. "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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characteristics of older African Americans enrolled in RTOG were not significantly different from those of African Americans in all other age groups except the youngest age group (20 to 54 years), according to data from the U.S. census. African Americans in the youngest age group were two to three times less likely to have completed high school (45.3 percent of African-American males and 52.3 percent of African-American females who were in this age group and who were enrolled in the trial did not complete high school, whereas the expected rates are 18.9 and 17.5 percent, respectively). Chamberlain et al., (1998) also found that the proportion of African-American men (11.9 percent) and women (16.3 percent) enrolled in RTOG significantly exceeded the proportion of patients who were African American and received radiation therapy as a primary treatment (10.4 and 8.7 percent, respectively, on the basis of SEER program data). Similarly, for prostate and cervical cancers, enrollment of African Americans significantly exceeded the expected proportions of African Americans with cancer at those sites. The level of enrollment of African Americans diagnosed with cancers of the brain, head and neck (among females only), and lung (among females only) did not differ significantly from the expected incidence. Enrollment of African-American men with lung cancer, however, fell significantly below the percentage of African-American men with lung cancer who received radiation therapy (7.9 percent enrolled versus 13.2 percent expected). As is the case with Tejeda et al., (1996), Chamberlain et al., (1998) do not provide data on ethnic minority groups other than African Americans, because the stratification of the sample by age and education precluded an analysis of the small number of individuals of other ethnic backgrounds enrolled in RTOG. Similarly, the report provides no socioeconomic data for other populations. It is important that comparable studies be done for low-income whites as well as for other populations.
Overall, the Clinical Trials Cooperative Groups appear to accrue ethnic minority populations in clinical trials at rates proportional to the rates of cancer among those groups. When examined by specific trial groups and types of cancers, however, there appear gaps in accrual that serve to suppress overall ethnic minority accrual.
CCOPs and MBCCOPs
As noted above, 51 CCOPs were funded in FY 1997 to enroll patients in prevention and treatment trials. NCI provided raw data on patient accrual to these trials between June 1996 and February 1997 but did not provide information on accrual by specific ethnic minority groups. These data indicate that of the 4,363 patients enrolled in treatment protocols, 664 (15.2 percent of the total) were ethnic minorities. As is the case with