Dr Fonkoua on Addressing Barriers to Cancer Clinical Trial Access

Lionel A. Kankeu Fonkoua, MD, medical oncologist, Department of Medical Oncology, Mayo Clinic, discusses the importance of addressing barriers to clinical trial access that patients with cancer may face and increasing patient access to routine, primary care.

Disparities in cancer care are multifaceted, as these issues involve several different parameters, Fonkoua begins. For example, social determinants of health, such as health literacy, health behaviors, social support, social needs, and access to health care, often contribute to cancer care disparities, Fonkoua emphasizes. Social determinants of health should always be considered when investigating reasons for barriers in access in cancer care, he says.

Moreover, most patients with cancer who are treated in academic centers have access to more specialized care than those treated in the community, as academic centers house most clinical trials, Fonkoua expands. This unequal access to care is important to consider because patients in minority populations often lack access to academic centers, which may be located far from where they live, Fonkoua notes. These patients may instead livein communities without a clinical trial infrastructure, Fonkoua says.

Overall, these patients do not have access to basic routine care, Fonkou continues, adding that these patients may also not have timely, appropriate cancer screenings. These disparities can also lead to delayed diagnosis in underserved patients, who then can potentially miss opportunities to receive the best treatments, which can include enrolling in clinical trials, he explains. Because of these notable disparities, the oncology community must begin to bridge the divide between routine, primary care, and clinical research, he emphasizes. When patients eventually have adequate access to routine primary care, their opportunities to receive timely cancer diagnoses will increase, Fonkoua notes. Patients with cancer who do not receive proper screening or diagnoses cannot be linked with appropriate care or enroll in potentially beneficial clinical trials, Fonkou concludes.