Patient and physician factors associated with participation in cervical and uterine cancer trials: an NRG/GOG247 study

Gynecol Oncol. 2015 Jul;138(1):101-8. doi: 10.1016/j.ygyno.2015.04.033. Epub 2015 Apr 30.

Abstract

Purpose: The aim of this study was to identify patient and physician factors related to enrollment onto Gynecologic Oncology Group (GOG) trials.

Methods: Prospective study of women with primary or recurrent cancer of the uterus or cervix treated at a GOG institution from July 2010 to January 2012. Logistic regression examined probability of availability, eligibility and enrollment in a GOG trial. Odds ratios (OR) and 95% confidence intervals (CI) for significant (p<0.05) results reported.

Results: Sixty institutions, 781 patients, and 150 physicians participated, 300/780 (38%) had a trial available, 290/300 had known participation status. Of these, 150 women enrolled (59.5%), 102 eligible did not enroll (35%), 38 (13%) were ineligible. Ethnicity and specialty of physician, practice type, data management availability, and patient age were significantly associated with trial availability. Patients with >4 comorbidities (OR 4.5; CI 1.7-11.8) had higher odds of trial ineligibility. Non-White patients (OR 7.9; CI 1.3-46.2) and patients of Black physicians had greater odds of enrolling (OR 56.5; CI 1.1-999.9) in a therapeutic trial. Significant patient therapeutic trial enrollment factors: belief trial may help (OR 76.9; CI 4.9->1000), concern about care if not on trial (OR12.1; CI 2.1-71.4), pressure to enroll (OR .27; CI 0.12-.64), caregiving without pay (OR 0.13; CI .02-.84). Significant physician beliefs were: patients would not do well on standard therapy (OR 3.6; CI 1.6-8.4), and trial would not be time consuming (OR 3.3; CI 1.3-8.1).

Conclusions: Trial availability, patient and physician beliefs were factors identified that if modified could improve enrollment in cancer cooperative group clinical trials.

Trial registration: ClinicalTrials.gov NCT01098630.

Keywords: Cervical cancer trials; Clinical trial enrollment; Gynecologic Oncology Group; Minority enrollment; NRG Oncology; Patient and physician factors; Uterine cancer trials.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Trials as Topic / methods*
  • Clinical Trials as Topic / psychology*
  • Decision Making
  • Female
  • Humans
  • Middle Aged
  • Patient Acceptance of Health Care
  • Patient Selection*
  • Physicians / psychology*
  • Prospective Studies
  • Uterine Cervical Neoplasms / psychology*
  • Uterine Cervical Neoplasms / therapy
  • Uterine Neoplasms / psychology*
  • Uterine Neoplasms / therapy
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT01098630