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Neal J. Meropol, Joanne S. Buzaglo, Jennifer Millard, Nevena Damjanov, Suzanne M. Miller, Caroline Ridgway, Eric A. Ross, John D. Sprandio and Perry Watts

Although clinical trial research is required for the development of improved treatment strategies, very few cancer patients participate in these studies. The purpose of this study was to describe psychosocial barriers to clinical trial participation among oncologists and their cancer patients. A survey was distributed to all medical oncologists in Pennsylvania and a subset of their patients. Relevant background information and assessment of practical and psychosocial barriers to clinical trial participation were assessed. Among 137 oncologists and 170 patients who completed the surveys, 84% of patients were aware of clinical trials, and oncologists and patients generally agreed that clinical trials are important to improving cancer treatment. However, oncologists and patients were more likely to consider clinical trials in advanced or refractory disease. When considering 7 potential barriers to clinical trials, random assignment and fear of receiving a placebo were ranked highly by both patients and oncologists. Patients identified fear of side effects as the greatest barrier to clinical trial participation, whereas oncologists ranked this psychosocial barrier as least important to their patients. Overall, the study found that although oncologists and patients are aware of clinical trials and have favorable attitudes toward them, psychosocial barriers exist for patients that may impact participation in clinical trials. Furthermore, important discrepancies exist between the perceptions of oncologists and those of patients regarding what the psychosocial barriers are. We concluded that characterizing oncologist and patient perceived barriers can help improve communication and decision making about clinical trials, such that participation may be optimized.

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Gaurav Kumar, Priyanka Chaudhary, Aiden Quinn and Dejun Su

Background: Barriers to clinical trial enrollment have been the subject of numerous research; however, the rate of clinical trial participation has not improved significantly over time. Studies often emphasize patient-related barriers, but

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5 5 8 8 Should Resource Constraints Guide Global Guidelines? Anderson Benjamin O. MD 09 2007 5 5 8 8 745 745 746 746 0050745 10.6004/jnccn.2007.0066 Barriers to Clinical Trial Participation as Perceived by Oncologists and Patients

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Henry Soo-Min Park

, studies suggest multilevel barriers to clinical trial accrual, especially for patients who are elderly, adolescent or young adult, female, ethnic/racial minorities, or socioeconomically disadvantaged. 4 Patients may be burdened by the expenses of travel

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Andrea Wang-Gillam and Kristina Williams

trial accrual. 7 Historically, insurance has also been a barrier to clinical trial participation, 8 particularly for patients seeking to enroll on early phase trials. To address this, our institution has designated personnel to assist in the clinical

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collaborations with payers, process improvement, removing economic barriers to clinical trials, and defining and measuring the right outcomes. Panelists agreed there is a need for patient education partnerships and access to those resources in order to enhance

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Lydia T. Madsen, Deborah A. Kuban, Seungtaek Choi, John W. Davis, Jeri Kim, Andrew K. Lee, Delora Domain, Larry Levy, Louis L. Pisters, Curtis A. Pettaway, John F. Ward, Christopher Logothetis and Karen E. Hoffman

One barrier to clinical trial enrollment is lack of awareness of available clinical trials. A survey of nearly 6000 patients with cancer found that 85% were either unaware or unsure that participation in clinical trials was an option, although 75% of

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Nicholas G. Zaorsky, Ying Zhang, Vonn Walter, Leila T. Tchelebi, Vernon M. Chinchilli and Niraj J. Gusani

not at initial therapy. Several barriers to clinical trial accrual have been proposed. Lara et al 4 reported that, compared with patients in clinical trials, those who declined trial enrollment were more likely to desire other treatment, live farther

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Ning Ning, Jingsheng Yan, Xian-Jin Xie and David E. Gerber

barriers to opening oncology clinical trials . J Clin Oncol 2007 ; 25 : 1288 ; author reply 1288 . 12. Dilts DM Sandler AB . Invisible barriers to clinical trials: the impact of structural, infrastructural, and procedural barriers to opening

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Carolyn E. Behrendt, Arti Hurria, Lusine Tumyan, Joyce C. Niland and Joanne E. Mortimer

to clinical trial participation by older women with breast cancer . J Clin Oncol 2003 ; 21 : 2268 – 2275 . 10. Simon MS Du W Flaherty L . Factors associated with breast cancer clinical trials participation and enrollment at a large