. "5 Advancing State-of-the-Art Treatment and Prevention." The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved. Washington, DC: The National Academies Press, 1999.
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Hispanic, 5.5 percent of females and 1.5 percent of males were African American, 1.5 percent of females and 0.4 percent of males were Asian American, and less than 0.3 percent of both the male and female populations were American Indian. MDA reported the accrual of no Hispanic individuals, whereas 9.2 percent (4 of 42) and 9.6 percent (5 of 52) of the enrolled patient population were African-American females and males, respectively. Only one Asian-American male was accrued to this trial group.
Among the large, nonspecialty clinical trial groups, the level of ethnic minority accrual appeared to be slightly less than those for the other clinical trial groups. The Cancer and Acute Leukemia Group B trial reported that in 1997, 16 percent of the enrolled patient population were ethnic minorities, whereas ECOG reported that 12 percent of females and 15 percent of males were ethnic minorities. RTOG and the Southwest Oncology Group (SWOG) fared similarly, as 16 percent of the females and 19 percent of the males enrolled in RTOG were ethnic minorities, whereas 17 percent of the females and 19 percent of the males enrolled in SWOG were ethnic minorities.
SWOG has conducted an analysis of its accrual to therapeutic trials between 1993 and 1996, comparing accrual rates to the percentage of cancer diagnoses in the U.S. among women, African Americans, and elderly people (ages 65 and older) at four cancer sites. As in the analysis of Tejeda et al., (1996), Unger and his colleagues (Unger et al., 1998) calculated expected values based on 1992 to 1994 SEER program incidence data and U.S. census data. Unger et al., (1998) found that the overall SWOG accrual rate for African Americans (10.2 percent) was almost identical to the estimated percentage of African Americans among U.S. cancer cases (10.1 percent). Similarly, the accrual rate for women (41 percent) was comparable to the estimated percentage of women among all cases of cancer in the U.S. (43 percent). The elderly, however, were substantially under-accrued, as 25 percent of SWOG's trial population was 65 or older, whereas 63 percent of cancer diagnoses occur among this population in the U.S. When examined by cancer site, Unger et al., (1998) found that the elderly were significantly under-accrued in breast, colon and rectal, and lung cancer trials, while African Americans were significantly under-accrued in lymphoma trials (7 percent accrual in SWOG, compared with 11 percent of African Americans among all lymphoma cases during the same period).
Similarly, Chamberlain et al., (1998) report on the sociodemographic characteristics of more than 4,000 patients enrolled in RTOG studies between January 1991 and June 1994, using SEER program and U.S. census data to determine the representativeness of the study sample to the overall U.S. population of cancer patients who have received radiation therapy. Using chi-square analyses, investigators determined that the educational