National cancer clinical trials: Children have equal access; adolescents do not

W. Archie Bleyer, Heriberto Tejeda, Sharon B. Murphy, Leslie L. Robison, Julie A. Ross, Bradley H Pollock, Richard K. Severson, Otis W. Brawley, Malcolm A. Smith, Richard S. Ungerleider

Research output: Contribution to journalArticlepeer-review

149 Scopus citations

Abstract

Purpose. To determine whether adolescents with cancer, who in comparison to younger patients have a higher cancer incidence and lower mortality reduction, have equal access to national cancer clinical trials. Methods. The ethnic/racial distribution of 29,859 subjects < 20 years of age entered onto National Cancer Institute-sponsored clinical trials between January 1, 1991, and June 30, 1994, was compared with the expected distribution of patients of the same age in the United States. Results. The Children's Cancer Group and Pediatric Oncology Group had 29,134 (97.6%) of the total study entries among < 20-year-old subjects during the 3.5 years of surveillance. The adult cooperative groups accounted for < 3% of the clinical trials entries in the 15-19-year age range. When analyzed nationally by region, the underrepresentation of the older adolescent subjects was universal. From other analyses, the two pediatric cooperative groups were estimated to have registered > 94% of the children < 15 years of age who were expected to have been diagnosed to have cancer, but only 21% of the cancer patients in the 1519-year age group. Conclusions. The national pediatric cancer cooperative groups allow the majority of American children < 15 years of age and their families equal opportunity to access clinical cancer trials, regardless of race or ethnic- ity. Among patients 15-19 years of age, however, > 75% are not being enrolled by any cooperative group sponsored by the National Cancer Institute. Thus, older adolescents are disadvantaged with respect to access to the national clinical trials, regardless of their race or ethnicity.

Original languageEnglish (US)
Pages (from-to)366-373
Number of pages8
JournalJournal of Adolescent Health
Volume21
Issue number6
DOIs
StatePublished - Dec 1997
Externally publishedYes

Keywords

  • Adolescents
  • Cancer
  • Children's Cancer Group
  • National cancer trials
  • Pediatric Oncology Group

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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