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Social determinants of health inequalities in early phase clinical trials in Northern England

Lookup NU author(s): Sarah Rae, Ellie Taylor, Joseph Hoben, Dr Christoph OingORCiD, Professor Alastair GreystokeORCiD, Professor Ruth Plummer

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© The Author(s) 2024.Background: Early phase clinical trials in Oncology represent a subspecialised area where UK patient selection is influenced by access to Experimental Cancer Medicine Centres (ECMCs). Equity of access with respect to social determinants of health (SDoH) were explored for two major ECMCs. Methods: A retrospective cohort study including all referrals to Newcastle and Manchester ECMCs in 2021 was completed. Consent to screening or pre-screening was stratified against SDoH characteristics, including: Index of Multiple Deprivation (IMD) decile, ethnicity and distance to centre. Results: 1243 patients were referred for trials. IMD quintile 1 (most deprived) patients had reduced likelihood of referral compared to expected population models (OR, 0.67; 95% CI: 0.55 to 0.80, p = <0.0001). IMD quintile 5 (least deprived) had increased likelihood of referral (OR, 1.46; 95% CI: 1.17 to 1.82, p = 0.0007). Living beyond median distance from Manchester reduced the likelihood of consenting to trials (OR, 0.72; 95% CI: 0.55 to 0.94, p = 0.015). Ethnicity data represented a White British propensity. Conclusions: Inequalities in socioeconomic and geographic factors influence referral and enrolment to early phase clinical trials in Northern England. This has implications for equity of access and generalisability of trial results internationally and warrants further study.


Publication metadata

Author(s): Rae S, Shaya S, Taylor E, Hoben J, Oluwashegun D, Lowe H, Haris N, Bashir S, Oing C, Krebs MG, Thistlethwaite FC, Carter L, Cook N, Greystoke A, Graham DM, Plummer R

Publication type: Article

Publication status: Published

Journal: British Journal of Cancer

Year: 2024

Pages: epub ahead of print

Online publication date: 24/06/2024

Acceptance date: 13/06/2024

Date deposited: 05/07/2024

ISSN (print): 0007-0920

ISSN (electronic): 1532-1827

Publisher: Springer Nature

URL: https://doi.org/10.1038/s41416-024-02765-w

DOI: 10.1038/s41416-024-02765-w

Data Access Statement: Data is available on reasonable request from the corresponding author.


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Funding

Funder referenceFunder name
CTRQQR-2021\100003
ECMCQQR-2022/100002
CRUK
NIHR

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