Low-income cancer patients are less likely to participate in clinical trials

A new study published Thursday in the journal JAMA Oncology has proven that low-income cancer patients are less likely to participate in clinical trials, and the study further identified factors responsible for this development among patients who are low-income earners.

The US researchers found that cancer patients with a total annual income of less than $50,000 are 32% less likely to participate in clinical trials for new drug researches, and patients from households earning below $20,000 are 75% less likely to enroll in clinical studies than patients from wealthier or high-income families.

The researchers adjusted for gender, race, age, travel distance to clinical test sites, and diagnosis details in reaching their conclusions for the study.

“Low-income patients are likely more sensitive about how to pay for clinical trial treatment, including direct costs like co-pays and co-insurance, or indirect or hidden costs such as taking time off work for extra clinic visits,” said lead study author Joseph Unger, a biostatistician at the Fred Hutchinson Cancer Research Center in Seattle.

Although earlier studies have established that finances play a big part in the access patients have to clinical trials, the current research shows that levels of income earnings was the predictor because this was assessed before participants chose to participate in clinical cancer trials.

For this particular study, about 1,262 patients were recruited to be analyzed in eight cancer clinics all over the US, and these participants were already diagnosed with lung, colorectal, or breast tumors.

The participants chose to participate in the study before deciding whether they wanted to be treated, and they were monitored over a six-month period to determine if they went ahead to take part in clinical trials or not.

A larger part of the patients were women with average college education, lesser than 65 years of age and living about 13 miles from where they were to be treated. Many of the participants had breast tumors, but about four in five of them were newly diagnosed with cancer.

About half of the participants’ household made a minimum $50,000 per annum but about 30% of these earned between $20,000 to $49,000. Nearly one out of five patients earned less than $20,000 per year.

In an email communication, Unger revealed that low-income patients do not necessarily have access to better treatment options and experimental therapies, and that all patients should have equal access to treatments regardless of their income levels.


When lower-income earners don’t have equal access to clinical trials, researchers do not kick off the trials in time and this makes it impossible to determine if the results of the proposed study would benefit the rich and the poor.

It is true that ethics frown upon the idea of paying patients to participate in a study, but under certain conditions it might be better if out-of-pocket expenses are waived to compensate or encourage participants, most especially if such expenses are not covered by insurance coverage.