Age Disparities in Cancer Clinical Trials Continue to Grow

While advancing age is the largest risk factor for a cancer diagnosis— the median age at which cancer is diagnosed is 66—in a recent analysis of more than 300 oncology randomized clinical trials, researchers found trial participants to be significantly younger than patients in the general population with the same tumor types. In a report published recently in JAMA Oncology, the authors state that the age disparity they identified is “pervasive and worsening.”

For the purposes of their study, the authors looked at clinical trials of treatments for the four most common cancers (breast, prostate, colorectal, and lung). Their analysis of 262,354 participants enrolled in 302 oncology clinical trials between 1994 and 2015; 249 trials (82.5% were industry-funded) found the median age of trial participants to be 6.49 years younger than the median age of other patients with the same cancers. The study found that age disparities were greater in industry trials compared with non-industry trials, and greater in trials for targeted systemic therapy and lung cancer. Calling that gap a “substantial difference,” the authors added that it seems to be widening. Their analysis revealed the difference between the median age of trial participants and population-based disease-site-specific median age to be growing at a rate of −0.19 years annually.

The study found that industry-funded trials were not significantly more likely to use age-based or performance status-based enrollment restrictions. The reason for the increased age disparities is unclear, and a better understanding of this observed association is needed to reduce this gap. One potential factor, the authors suggest, is that industry-funded trials may be more available at cancer programs that treat a greater proportion of younger patients. With the ever-growing role of industry in funding clinical trials, the study’s authors state, “efforts to understand and address age disparities are necessary to ensure generalizability of trial results as well as equity in trial access.”

It is estimated that by the year 2030, 70 percent of all cancers will occur among adults age 65 and older. Understanding how cancer and its treatments affect older adults in particular is critical for the delivery of high-quality, patient-centered care. ACCC has developed a variety of resources to identify barriers and best practices for serving this growing patient population with its Multidisciplinary Approaches to Caring for Geriatric Patients with Cancer project. Consisting of a comprehensive publication and a series of webinars on treating older adults with cancer, the project is a resource designed to help multidisciplinary care team members better understand the unique considerations required when treating an older patient population. Learn more.