Oncologists provided less clinical trial information to black patients
During patient visits, oncologists discussed various aspects of clinical trials nearly twice as frequently with white patients as they did with black patients, according to findings presented at the Fifth AACR Conference on The Science of Cancer Health Disparities in San Diego.
“Taking a close look at interactions and the language used can help us to identify patterns of behavior and make the necessary improvements that may ultimately lead to decisions that are in the best interest of each patient,” Susan Eggly, PhD, associate professor of oncology in the population studies and disparities program at Wayne State University School of Medicine and the Barbara Ann Karmanos Cancer Institute in Detroit, said in a press release.
Eggly and colleagues aimed to determine whether oncologists communicate differently with black patients and white patients, specifically in terms of offers to participate in clinical trials.
The data were taken from a study by Albrecht and colleagues, who transcribed video-recorded oncology interactions containing an offer of a cancer trial. The study included 11 black patients and 11 white patients.
The researchers conducted a discourse analysis to evaluate for the five basic elements of consent, which include purpose, risks and benefits of the trial, alternatives to participating and the voluntary nature of trial participation.
Word count served as an objective measure of face-to-face discussion. Other measures included the number of times the elements of clinical trials were mentioned, as well as the word count of discussions in which clinical trial topics were mentioned.
The mean word count was 4,877.73 for blacks and 7,247.18 for whites.
Clinicians mentioned clinical trials a mean of 2.73 times to blacks and 4.27 times to whites.
When clinical trials were mentioned, the word count was less for blacks (1,089.64 vs. 1,867.09).
The mean word count also was less for blacks regarding the elements of consent during discussions of purpose ( 90.91 vs. 181.22). When risks were discussed, clinicians said 211.9 words to blacks and 390.27 words to whites. The risks were mentioned 1.91 times to blacks and 3.18 times to whites.
Clinicians also mentioned voluntary participation more frequently to whites than blacks (2.1 vs. 1.55).
“Minority patients tend to receive less information, which could, in part, explain under-enrollment by minorities in clinical cancer trials,” Eggly said. “These disparities could also lead to minority patients being enrolled in trials without fully understanding the purpose of the trial and the potential risks of participation.”
For more information:
Eggly S. #A11. Presented at: The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Oct. 27-30, 2012; San Diego.