Poor Patients Less Likely To Participate in Medical Research

Joseph M. Unger, PhD MS Assistant Member Fred Hutchinson Cancer Research Center Seattle, WAMedicalResearch.com Interview with:
Joseph M. Unger, PhD MS
Assistant Member
Fred Hutchinson Cancer Research Center
Seattle, WA

Medical Research: What is the background for this study? What are the main findings?

Response: In a prior study, we identified patient-level income as an important predictor of clinical trial participation. Because this was one of many demographic and socioeconomic factors that we examined, we sought to confirm the finding in this new study using prospective data. Again, we found that patient-level income predicted clinical trial participation. Patients with household income <$50,000/year had a 32% lower odds of participating in clinical trials than patients with household income >$50,000/year. This confirmed our previous observation and provided strong evidence that the observation of income disparities in clinical trial enrollment is valid.

Medical Research: What should clinicians and patients take away from your report?

Response: Clinicians should be aware that lower income patients may be more likely to decline to participate in clinical trials due to direct costs (such as copays or coinsurance) or indirect costs (such as travel costs or time off work). This is important for both researchers and patients. For researchers, improved enrollment of lower income patients would help speed the conduct of clinical trials, hastening the development of new treatments, and would better assure the applicability of clinical trial results to all income levels. For patients, clinical trial treatments represent the newest available treatments, so such treatments should be equally available to patients of all income levels.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Future work should seek to clarify which specific costs are barriers, and to identify ways to help lower income patients with those costs.


Unger JM, Gralow JR, Albain KS, Ramsey SD, Hershman DL. Patient Income Level and Cancer Clinical Trial Participation: A Prospective Survey Study. JAMA Oncol.Published online October 15, 2015. doi:10.1001/jamaoncol.2015.3924.

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Joseph M. Unger, PhD MS (2015). Poor Patients Less Likely To Participate in Medical Research 

Last Updated on October 16, 2015 by Marie Benz MD FAAD