. "5 Advancing State-of-the-Art Treatment and Prevention." The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved. Washington, DC: The National Academies Press, 1999.
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the Clinical Trials Cooperative Groups, accrual of ethnic minorities varied considerably with the site of the CCOP. Compared with the percentage of ethnic minorities residing in the state in which the CCOP is located, it was found that only 12 of the 51 CCOPs met or exceeded this percentage of accrual of ethnic minorities. (It should be noted that the percentage of ethnic minority residents in a state is only a crude standard for accrual, given that cancer incidence rates for various ethnic groups within a population may not be equivalent to their percentages within the total population. Data on the percentage of ethnic minority residents within a CCOP catchment area were not available for all CCOPs.) Of those CCOPs that reported high rates of accrual of ethnic minorities, those in the Oakland, California; Tampa, Florida; Miami Beach, Florida; and Manhassett, New York, reported accrual rates of 32 to 50 percent. Data on patient accrual in four of the CCOPs were unavailable.
In CCOP prevention trials, the rate of accrual of ethnic minorities was poor. Data provided by NCI revealed that of the 4,172 patients enrolled in prevention trials, 289 (6.9 percent of the total) were ethnic minorities. Only 5 of the 51 CCOPs were able to enroll ethnic minority patients at rates equivalent to the proportion of ethnic minorities living in the states in which CCOPs were located. Furthermore, only the Miami Beach and Tampa sites were able to enroll ethnic minority subjects at rates of one-third or more of the total subject population. Data on patient accrual from four CCOP sites were missing.
The eight MBCCOPs appear to have increased the numbers of ethnic minority patients in the overall CCOP pool, yet in some cases they have not performed better than the CCOPs accruing the highest numbers of ethnic minorities. One trial group (in Richmond, Virginia) did not recruit a greater proportion of ethnic minorities in treatment (31 percent) and prevention (24 percent) trials than the proportion of ethnic minorities in the catchment area (38 percent). Two other MBCCOPs reported less than 50 percent ethnic minority enrollment in treatment and prevention trials. In addition, the numbers of ethnic minorities brought into clinical trials via MBCCOPs between June 1996 and February 1997 are small: although data are missing for one of the eight MBCCOPs, the seven remaining groups brought only an additional 215 ethnic minority patients into treatment trials and 102 ethnic minority patients into prevention trials. Overall, 79 percent of the patients enrolled in MBCCOP treatment trials were ethnic minorities, whereas 58 percent of the subjects enrolled in prevention trials were ethnic minorities.
Cancer Prevention Trials
As noted above and in Chapter 3, NCI sponsors five large cancer prevention