Background 

A clinical trial is a type of research study that helps doctors find new and better ways to prevent, test for, diagnose, and treat diseases. For people with bladder cancer, clinical trials have already led to earlier detection tests, new drugs that improve survival, and better surgery and radiation techniques that protect quality of life. 

For these studies to truly help all people with bladder cancer, the patients who join clinical trials need to reflect the real population of bladder cancer patients. This means including people of different ages, races, ethnicities, and genders. When that happens, doctors can better understand why a treatment works well for some patients but not for others. 

What the Study Proposes to Address 

Right now, many groups of people with bladder cancer are not well represented in clinical trials. This creates gaps and unfairness in care. To understand why, we need to look not only at personal factors, but also at social determinants of health—conditions that shape people’s daily lives. 

For example, some patients may live in communities without hospitals that offer clinical trials. Others may lack reliable transportation, attend underfunded schools, or work in jobs that don’t allow time off for medical appointments. These barriers make it harder for certain communities to join trials and benefit from them. 

This study will explore both individual and community-level factors that prevent fair participation in bladder cancer clinical trials. 

Why This Research is Important 

If some groups are left out of clinical trials, the results may not apply to them—and that leads to unequal treatment outcomes. By studying the reasons behind these gaps, researchers can develop solutions to ensure all patients have a fair chance to join clinical trials. 

The ultimate goal is to make bladder cancer care more equal by giving every patient, no matter their background or situation, access to promising new treatments through clinical trials. 

Final Report Summary 

This research looked at why many people with bladder cancer aren’t getting the chance to join clinical trials. Clinical trials are important studies that test new ways to treat cancer and can lead to better results and improved quality of life. But not all patients are represented equally. People from disadvantaged or historically marginalized communities often don’t participate as much in these trials. 

The researchers focused on something called the Social Vulnerability Index, which measures how much support or hardship exists in a community. They wanted to know if this index affected how likely people were to know about, talk about, or join a clinical trial. What they found was clear: the more vulnerable a community was, the less likely its people were to be aware of or take part in a trial. This was true even more than income or education level, which were already known to affect participation. 

They also discovered that these communities had fewer clinical trials available nearby, even when factors like population size or cancer rates were considered. Worse, the gap in availability is growing. 

This study shows how important it is to bring clinical trial opportunities to the communities that need them most so that everyone has an equal chance at better cancer care. 

Sekar, R. R., Herrel, L. A., & Stensland, K. D. (2024). Social Determinants of Health and the Availability of Cancer Clinical Trials in the United States. JAMA network open, 7(5), e2410162. https://doi.org/10.1001/jamanetworkopen.2024.10162

Sekar, R. R., Maganty, A., Stensland, K. D., & Herrel, L. A. (2025). Association of Community-Level Social Vulnerability With Clinical Trial Discussion and Participation Among Cancer Survivors. JCO oncology practice, 21(2), 235–244. https://doi.org/10.1200/OP.24.00206

ASCO Conquer Cancer Foundation Merit Award, 2024

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