Improving Rural Clinical Trial Enrollment: Recommendations From the Rural Health Working Group of the Alliance Clinical Trials Network
Cet article présente les recommandations du "Rural Health Working Group of the Alliance Clinical Trials Network" pour améliorer l'inclusion des patients des zones rurales dans les essais cliniques de cancérologie
Individuals with cancer who live in rural areas of the United States face limited access to medical oncology providers, face long travel times for standard-of-care cancer treatment, and lack opportunities to participate in clinical trials.1,2 A 2019 ASCO report Closing the Rural Cancer Care Gap provided a succinct overview of the challenges of rural cancer care and suggested solutions to address rural disparities.3 Of primary interest is improving the clinical trial infrastructure to encourage enrollment of rural populations through system-level changes.
Rural regions across the United States lack access to comprehensive cancer centers6 and have significantly lower density of oncologists than urban areas.2,7 Furthermore, critical access hospitals, a lifeline of health care in rural regions, offer limited cancer treatment options for patients, in general, and rarely offer clinical trials.8 These geographic access barriers lead to substantial burden for patients and their caregivers just to receive standard therapies for cancer care. When clinical trials require additional appointment and follow-up visits, trial participation by rural patients is diminished.9
Journal of Clinical Oncology , résumé, 2023