other racial groups. On the basis of SEER program data (1989 to 1991 crude incidence data), the expected distribution of patients of the same age in the United States was 9.1 percent for Hispanic children, 10.7 percent for African-American children, and 4.3 percent for other ethnic groups. The authors found that the level of ethnic minority enrollment was equal to or greater than the rate of cancer for 24 to 27 subgroups.

Among the pediatric specialty clinical trial groups, NWTS and IRS appeared to have a high level of representation of ethnic minority patients, with 38 percent of females and 34 percent of males enrolled in NWTS identified as ethnic minorities and 30 percent of females and 36 percent of males enrolled in IRS identified as ethnic minorities. More than half of the ethnic minority females in NWTS were African American (20 percent overall), whereas less than 4 percent each were Asian American, American Indian, or other groups.

Among the adult specialty clinical trial groups, GOG enrolled 21 percent minority women. Of the 1,604 women accrued in 1997, 5.4 percent were Hispanic, 12.8 percent were African American, 2.3 percent were Asian American, and 0.2 percent were American Indian. NSABP reported data on enrollment to 5 treatment trials, including breast, colon, and rectal cancer treatment protocols. Among the colon and rectal cancer trials, 86 percent of the 267 males enrolled in this trial were identified as white, 5.2 percent were identified as Hispanic, 7.1 percent were identified as African American, and 0.3 percent were identified as Asian American. No American Indian men were accrued in these trials. Among the 240 women enrolled in these trials, 85 percent were identified as white, whereas 1.7, 10.4, and 1.2 percent were identified as Hispanic, African American, and Asian American, respectively. One American Indian woman was recruited into this trial. Similarly, of the 2,175 women recruited into NSABP's breast cancer treatment trials, 1,842 (85 percent) were white and 175 (9.0 percent) were African American. NSABP did not collect more detailed data on ethnicity in two of its breast cancer treatment protocols (instead, data were collected on the basis of a former categorization system), but reported that 5.4 percent of women in these trials were of "other" ethnic minority groups. Three newer breast cancer treatment trials did include detailed ethnicity data in accordance with NIH guidelines and revealed that 2.6 percent of the women enrolled were Hispanic, 1.0 percent were Asian American, 0.3 percent were American Indian, and 1.5 percent were of other ethnic minority backgrounds.

The small, regional clinical trial groups experienced low ethnic minority accrual overall. NCCTG was able to enroll only 11 percent female ethnic minority and 4 percent male ethnic minority patients, whereas MDA enrolled 12 percent ethnic minority patients overall. Among NCCTG's patient population, 3.1 percent of females and 1.5 percent of males were



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