(A150) The effects of socioeconomic status on enrollment in clinical trials for head and neck cancer

Introduction: Enrollment in cancer clinical trials (CCTs) is vital for improving survival outcomes among cancer patients. However, patients with limited resources, including the uninsured and racial/ethnic minorities, are underrepresented in CCTs, particularly for head and neck cancer. This study analyzed one year of patient enrollment at our institution to assess the impact of socioeconomic status (SES) and distance from the cancer center on CCT participation.

Methods: We utilized a prospective multidisciplinary clinic database to identify patients deemed potentially eligible for a clinical trial during their initial visit. Eligibility and enrollment data were extracted from medical records, while SES and distance were estimated using patient zip codes. Univariate analyses (chi-squared test and t-test) were performed.

Results: Of the 192 patients included (May 2023–April 2024), 59 enrolled in a trial, 23 were ineligible despite interest, and 110 declined enrollment. Univariate analysis revealed significant associations for sex (males more likely to enroll; p = 0.04) and distance from the trial site (p = 0.03). Enrolled patients lived an average of 40 miles from the center, compared to 70 miles for those who declined. Patients with stage IV disease were less likely to enroll, though this was marginally significant (p = 0.052). Age, race/ethnicity, median income, insurance status, and Charlson comorbidity index were not significantly associated with enrollment. Multivariate analyses are ongoing.

Conclusions: Our findings suggest that patient sex, proximity to the trial site, and disease stage may influence CCT enrollment for head and neck cancer. Study limitations include its retrospective design and reliance on zip code-based SES estimates. Further prospective studies are needed to validate these findings and assess their generalizability to broader patient populations.