References for Module 1

This training is based on the best available research evidence and peer-reviewed literature.

  1. American Association for Cancer Research. Cancer Disparities Progress Report: 2024. Philadelphia: American Association for Cancer Research; 2024. Available from http://www.CancerDisparitiesProgressReport.org/
  2. American Cancer Society Cancer Action Network. Barriers To Patient Enrollment In Therapeutic Clinical Trials For Cancer-A Landscape Report ; 2018. https://www.fightcancer.org/policy-resources/clinical-trial-barriers
  3. American Cancer Society. Cancer Facts & Figures 2025. Atlanta: American Cancer Society; 2025. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2025/2025-cancer-facts-and-figures-acs.pdf
  4. Balogh EP, Levit LA, Unger JM, Accordino MK, Chism DD, Kirkwood MK, Parsons HM, Patel MI, Peppercorn JM, Polite BN, Sedrak MS, Sharma P, Subbiah IM, Temel JS, Yabroff KR, Osarogiagbon RU. ASCO State of Cancer Care in America Special Report 2025: Access to Cancer Clinical Trials in the United States. JCO Oncol Pract. 2025 Dec;21(12):1746-1758. doi:10.1200/OP-25-00233 . Epub 2025 Oct 6. PMID: 41052457.
  5. Chavez-MacGregor M, Unger JM, Moseley A, Ramsey SD, Hershman DL. Survival by Hispanic ethnicity among patients with cancer participating in SWOG clinical trials. Cancer. 2018;124(8):1760-1769. doi:10.1002/cncr.31241
  6. Coney J. Racial Bias in Clinical Trials: What You Need to Know. Retina Today. March 2021. https://retinatoday.com/articles/2021-mar/racial-bias-in-clinical-trials-what-you-need-to-know
  7. De Las Heras B, Daehnke A, Saini KS, et al. Role of decentralized clinical trials in cancer drug development: Results from a survey of oncologists and patients. Digital Health. 2022;8:205520762210999. doi:10.1177/20552076221099997
  8. Dess RT, Hartman HE, Mahal BA, et al. Association of Black Race With Prostate Cancer-Specific and Other-Cause Mortality. JAMA Oncol. 2019;5(7):975-983. doi:10.1001/jamaoncol.2019.0826
  9. Duma N, Vera Aguilera J, Paludo J, et al. Representation of minorities and women in oncology clinical trials: review of the past 14 years. JOP. 2018;14(1):e1-e10. doi:10.1200/JOP.2017.025288
  10. Durden K, Hurley P, Butler DL, Farner A, Shriver SP, Fleury ME. Provider motivations and barriers to cancer clinical trial screening, referral, and operations: Findings from a survey. Cancer. 2024;130(1):68-76. doi:10.1002/cncr.35044
  11. Ebrahimi H, Megally S, Plotkin E, et al. Barriers to clinical trial implementation among community care centers. JAMA Netw Open. 2024;7(4):e248739. doi:10.1001/jamanetworkopen.2024.8739
  12. Eggly S, Barton E, Winckles A, Penner LA, Albrecht TL. A disparity of words: racial differences in oncologist-patient communication about clinical trials. Health Expectations. 2015;18(5):1316-1326. doi:10.1111/hex.12108
  13. Engelbak Nielsen Z, Eriksson S, Schram Harsløf LB, et al. Are cancer patients better off if they participate in clinical trials? A mixed methods study. BMC Cancer. 2020;20(1):401. doi:10.1186/s12885-020-06916-z
  14. Goel S, Negassa A, Ghalib MH, et al. Outcomes Among Racial and Ethnic Minority Patients With Advanced Cancers in Phase 1 Trials: A Meta-Analysis. JAMA Netw Open. 2024;7(7):e2421485. doi:10.1001/jamanetworkopen.2024.21485
  15. Hamel LM, Penner LA, Albrecht TL, Heath E, Gwede CK, Eggly S. Barriers to clinical trial enrollment in racial and ethnic minority patients with cancer. Cancer Control. 2016;23(4):327-337. doi:10.1177/107327481602300404
  16. Javier-DesLoges J, Nelson TJ, Murphy JD, McKay RR, Pan E, Parsons JK, Kane CJ, Kader AK, Derweesh IH, Nodora J, Patel SP, Martinez ME, Rose BS. Disparities and trends in the participation of minorities, women, and the elderly in breast, colorectal, lung, and prostate cancer clinical trials. Cancer. 2022;128(4):770-777. doi:10.1002/cncr.33991
  17. Joseph G, Dohan D. Diversity of participants in clinical trials in an academic medical center: The role of the ‘Good Study Patient?’ Cancer. 2009;115(3):608-615. doi:10.1002/cncr.24028
  18. Kanapuru B, Fernandes LL, Fashoyin-Aje LA, et al. Analysis of racial and ethnic disparities in multiple myeloma US FDA drug approval trials. Blood Advances. 2022;6(6):1684-1691. doi:10.1182/bloodadvances.2021005482
  19. Knelson LP, Cukras AR, Savoie J, Agarwal A, Guo H, Hu J, Fell G, Lederman R, Hughes ME, Winer EP, Lin NU, Tolaney SM. Barriers to Clinical Trial Accrual: Perspectives of Community-Based Providers. Clin Breast Cancer. 2020 Oct;20(5):395-401.e3. doi:10.1016/j.clbc.2020.05.001 . Epub 2020 May 7. PMID: 32605813.
  20. Langford AT. Health communication and decision making about vaccine clinical trials during a pandemic. Journal of Health Communication. 2020;25(10):780-789. doi:10.1080/10810730.2020.1864520
  21. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology; 2026. https://www.nccn.org/guidelines/category_1
  22. Niranjan SJ, Martin MY, Fouad MN, et al. Bias and stereotyping among research and clinical professionals: Perspectives on minority recruitment for oncology clinical trials. Cancer. 2020;126(9):1958-1968. doi:10.1002/cncr.32755
  23. Oyer RA, Hurley P, Boehmer L, et al. Increasing racial and ethnic diversity in cancer clinical trials: an American Society of Clinical Oncology and Association of Community Cancer Centers joint research statement. JCO. 2022;40(19):2163-2171. doi:10.1200/JCO.22.00754
  24. Rencsok EM, Bazzi LA, McKay RR, et al. Diversity of Enrollment in Prostate Cancer Clinical Trials: Current Status and Future Directions. Cancer Epidemiol Biomarkers Prev. 2020;29(7):1374-1380. doi:10.1158/1055-9965.EPI-19-1616
  25. Rocque GB, Courtney A, Frazier RM, et al. Abstract P6-09-04: Oncologist-reported Barriers and Facilitators to enrolling patients in optimization trials that test less intense cancer treatment. Cancer Research. 2023;83(5_Supplement):P6-09-04. doi:10.1158/1538-7445.SABCS22-P6-09-04
  26. Snyder RA, He J, Le-Rademacher J, et al. Racial differences in survival and response to therapy in patients with metastatic colorectal cancer: A secondary analysis of CALGB/SWOG 80405 (Alliance A151931). Cancer. 2021;127(20):3801-3808. doi:10.1002/cncr.33649
  27. Unger JM, Cook E, Tai E, Bleyer A. The role of clinical trial participation in cancer research: barriers, evidence, and strategies. Am Soc Clin Oncol Educ Book. 2016;35:185-198.
  28. Unger JM, Hershman DL, Till C, et al. “When Offered to Participate”: A Systematic Review and Meta-Analysis of Patient Agreement to Participate in Cancer Clinical Trials. J Natl Cancer Inst. 2021;113(3):244-257. doi:10.1093/jnci/djaa155
  29. Unger JM, Moseley A, Symington B, Chavez-MacGregor M, Ramsey SD, Hershman DL. Geographic Distribution and Survival Outcomes for Rural Patients With Cancer Treated in Clinical Trials. JAMA Netw Open. 2018;1(4):e181235. Published 2018 Aug 3. doi:10.1001/jamanetworkopen.2018.1235
  30. Unger JM, Shulman LN, Facktor MA, Nelson H, Fleury ME. National estimates of the participation of patients with cancer in clinical research studies based on Commission on Cancer accreditation data. JCO. 2024;42(18):2139-2148. doi:10.1200/JCO.23.01030
  31. Wallington SF, Luta G, Noone AM, et al. Assessing the awareness of and willingness to participate in cancer clinical trials among immigrant Latinos. J Community Health. 2012;37(2):335-343. doi:10.1007/s10900-011-9450-y
  32. Weill Cornell Medicine. Here’s What We Know: A Guide to Clinical Trial Costs ; 2026. https://weillcornell.org/news/here%E2%80%99s-what-we-know-a-guide-to-clinical-trial-costs
  33. Wong AR, Sun V, George K, et al. Barriers to participation in therapeutic clinical trials as perceived by community oncologists. JCO Oncology Practice. 2020;16(9):e849-e858. doi:10.1200/JOP.19.00662