Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

How does social isolation and socioeconomic status affect cancer trial participation? Results from PEARLER, prospective dataset of patients entering early phase trials in NSW  (#308)

Kevin Lin 1 , Udit Nindra 1 , Christina Teng 2 , Joe Wei 2 3 , Adam Cooper 1 , Kate Wilkinson 1 , Aflah Roohullah 1 , Charlotte Lemech 2 3 , Wei Chua 1 , Abhijit PAL 1
  1. Department of Medical Oncology, Liverpool Hospital, Liverpool, NSW, Australia
  2. Scientia Clinical Research, Randwick, NSW, Australia
  3. Prince of Wales Hospital, Randwick, NSW, Australia

Background/Aims: Many barriers can affect patient enrolment in early phase clinical trials (EPCTs) and understanding them is essential for achieving equitable access and improving generalisability of trial findings. Recently, more attention has been paid to cancer outcome disparities that arise from social isolation and socio-economic inequality. By analysing prospectively captured data during clinical trial recruitment in NSW, we examine whether living alone and linguistic diversity – factors which could underpin social isolation – in addition to economic disadvantage influences EPCT participation. 

Methods: All participants enrolling into EPCTs across two major clinical trials units in NSW were recruited. Participants undertook a baseline demographic survey at commencement of their EPCT. Details regarding EPCT, participant background including basic demographics, living situation and location of primary residence were included. Currently, 84 patients have been prospectively recruited. 

Results: Of the 84 recruited patients, the median age was 64 years (IQR: 55-71), forty (48.0%) were male, eighteen (21.0%) self-identified as culturally diverse and seventeen (20%) as linguistically diverse. Only six participants (7.0%) nominated that they were living alone as compared to with family and amongst them, none identified as linguistically diverse. Additionally, 27 (32%) patients resided in the lowest SES quintile. 

Conclusion: Our findings suggest that living alone and linguistic diversity may discourage EPCT enrolment. Furthermore, this dataset aligns with previous research demonstrating how social isolation and limited English proficiency reduces healthcare participation – these intersecting vulnerabilities could coalesce and portend poor outcomes. Considering the demographic trend towards increasing single-person households, prospective reporting of such disparities underscore the need for centres to account for limited social supports when ensuring equitable trial recruitment. Interestingly, a disproportionate representation of patients from the lowest SES quintile in this cohort may belie an inability to self-fund advanced therapies although further characterisation of the impact of economic disadvantage is required.