DISCUSSION OF CLINICAL TRIALS ON THE CANCER INFORMATION SERVICE CALL LINE

Purpose: Decisions about participation in cancer clinical trials (CTT) are difficult, and adult participation  is very low. One barrier to participation is limited awareness and lack of information on trials. In order to increase CTT participation and access to quality care for all cancer patients -- especially from underserved communities -- it is critical to understand who is receiving information regarding clinical trials and who may not be.  NCI’s Cancer Information Service (CIS) provides information on all aspects of cancer, including clinical trials. Our objective was to explore the prevalence and correlates of discussions about CTTs during CIS calls.

Method: We analyzed information on all calls to the CIS during 2006 and 2007. Information available for all callers (n=241,445) included: type of caller, cancer site of the patient, language of the call (Spanish or English), and callers’ initial discussion topic(s). Additional information on sociodemographic characteristics of callers was collected for a subset of callers (n=41,991).

Result: The percentage of calls to CIS that included discussions of CTTs was 6.86% for all callers, 9.96% for patients, and 11.42% for family members. Discussions of CTTs were substantially more common for English than Spanish language calls (7.12% vs. 1.76%), for Whites than Blacks (9.37% vs. 5.11%), and almost 7 times as common for individuals with post graduate school education than those with less than a high school education (14.8% vs. 2.61%).  Multivariate regression showed the following significant associations for CTTs discussions: type of caller (AOR 6.09 patients, 6.19 family members; ref. all others), Spanish language calls (AOR 0.70), Black race (AOR 0.52), education (AOR 1.85 some college, 2.45  college graduate, and 3.05  post-graduate education compared to less than high school), and income (AOR 1.38-1.86 higher income categories).

Conclusion: Discussions of CTTs on CIS calls are quite infrequent, even for cancer patients and their family members. In addition, there are substantial disparities in who is having discussions of CTTs. Interventions to improve the frequency and content of CIS discussions of CTTs will increase knowledge of CTTs among cancer patients and their families, and may improve informed decision making about CTT participation.