Men of Color Continue To Be Underrepresented in Prostate Cancer Clinical Trials

Prostate cancer is the second most diagnosed cancer among men in the United States, and non-Hispanic black men bear a disproportionate burden of prostate cancer incidence and mortality compared with their non-Hispanic white peers. 

Despite these disparities, an analysis of enrollment in prostate cancer clinical trials by Harvard researchers found that black or African American men are underrepresented in prostate cancer clinical trials. 

“We hope that this study broadly calls attention to the drastic underrepresentation of minority men in prostate cancer clinical trials, despite the increasing evidence of the racial disparities that exist in prostate cancer incidence and outcomes,” said Emily Rencsok, an MD/PhD student at the Harvard T.H. Chan School of Public Health in Boston and lead author of the study published in the AACR journal Cancer Epidemiology, Biomarkers, and Prevention. 

She pointed out that about 22 percent of prostate cancer cases occur in non-Hispanic black men, while less than 60 percent of cases occur in non-Hispanic white men. But in the clinical trials the research team studied, the proportion of black or African American men in the trials dropped from 11.3 percent in 1995 to 2.8 percent in 2014. Overall, white men made up 96 percent of the participants in the 59 clinical trials included in the study, Rencsok said.

Clinical trials are used to test new ways to prevent, detect, or treat diseases. Many people participate in trials in hopes of benefiting from innovative treatment approaches or promising investigational therapeutics. Of the 59 trials analyzed in this study, 51 were treatment trials, four were prevention trials, and four were screening trials, representing approximately 844,000 men. Of these men, over 745,000 participated in a screening trial.

“In recent decades, we have continued to learn about the racial disparities in prostate cancer incidence and mortality, yet our trial enrollment is mostly comprised of white men and does not reflect the populations that are most affected by this disease,” Rencsok said. 

“I think that we, as both a scientific and a clinical community, need to continue to dedicate intentional and specific resources toward the recruitment of underrepresented men into prostate cancer trials,” Rencsok added. “Further, we should focus efforts into supporting the clinical trial infrastructure in the medical centers that predominantly serve underrepresented populations, both in the United States and globally.”

An abstract of the study can be found here.