TY - JOUR
T1 - National cancer clinical trials
T2 - Children have equal access; adolescents do not
AU - Bleyer, W. Archie
AU - Tejeda, Heriberto
AU - Murphy, Sharon B.
AU - Robison, Leslie L.
AU - Ross, Julie A.
AU - Pollock, Brad H.
AU - Severson, Richard K.
AU - Brawley, Otis W.
AU - Smith, Malcolm A.
AU - Ungerleider, Richard S.
PY - 1997/12
Y1 - 1997/12
N2 - Purpose. To determine whether adolescents with cancer, who in comparison to younger patients have a higher cancer incidence and lower mortality reduction, have equal access to national cancer clinical trials. Methods. The ethnic/racial distribution of 29,859 subjects < 20 years of age entered onto National Cancer Institute-sponsored clinical trials between January 1, 1991, and June 30, 1994, was compared with the expected distribution of patients of the same age in the United States. Results. The Children's Cancer Group and Pediatric Oncology Group had 29,134 (97.6%) of the total study entries among < 20-year-old subjects during the 3.5 years of surveillance. The adult cooperative groups accounted for < 3% of the clinical trials entries in the 15-19-year age range. When analyzed nationally by region, the underrepresentation of the older adolescent subjects was universal. From other analyses, the two pediatric cooperative groups were estimated to have registered > 94% of the children < 15 years of age who were expected to have been diagnosed to have cancer, but only 21% of the cancer patients in the 1519-year age group. Conclusions. The national pediatric cancer cooperative groups allow the majority of American children < 15 years of age and their families equal opportunity to access clinical cancer trials, regardless of race or ethnic- ity. Among patients 15-19 years of age, however, > 75% are not being enrolled by any cooperative group sponsored by the National Cancer Institute. Thus, older adolescents are disadvantaged with respect to access to the national clinical trials, regardless of their race or ethnicity.
AB - Purpose. To determine whether adolescents with cancer, who in comparison to younger patients have a higher cancer incidence and lower mortality reduction, have equal access to national cancer clinical trials. Methods. The ethnic/racial distribution of 29,859 subjects < 20 years of age entered onto National Cancer Institute-sponsored clinical trials between January 1, 1991, and June 30, 1994, was compared with the expected distribution of patients of the same age in the United States. Results. The Children's Cancer Group and Pediatric Oncology Group had 29,134 (97.6%) of the total study entries among < 20-year-old subjects during the 3.5 years of surveillance. The adult cooperative groups accounted for < 3% of the clinical trials entries in the 15-19-year age range. When analyzed nationally by region, the underrepresentation of the older adolescent subjects was universal. From other analyses, the two pediatric cooperative groups were estimated to have registered > 94% of the children < 15 years of age who were expected to have been diagnosed to have cancer, but only 21% of the cancer patients in the 1519-year age group. Conclusions. The national pediatric cancer cooperative groups allow the majority of American children < 15 years of age and their families equal opportunity to access clinical cancer trials, regardless of race or ethnic- ity. Among patients 15-19 years of age, however, > 75% are not being enrolled by any cooperative group sponsored by the National Cancer Institute. Thus, older adolescents are disadvantaged with respect to access to the national clinical trials, regardless of their race or ethnicity.
KW - Adolescents
KW - Cancer
KW - Children's Cancer Group
KW - National cancer trials
KW - Pediatric Oncology Group
UR - http://www.scopus.com/inward/record.url?scp=0030734508&partnerID=8YFLogxK
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U2 - 10.1016/S1054-139X(97)00110-9
DO - 10.1016/S1054-139X(97)00110-9
M3 - Article
C2 - 9401854
AN - SCOPUS:0030734508
SN - 1054-139X
VL - 21
SP - 366
EP - 373
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 6
ER -