title: Case-linked analysis of clinical trial enrollment among adolescents and young adults at a National Cancer Institute-designated comprehensive cancer center.
abstract: BACKGROUND
  Poor accrual to cancer clinical trials may contribute to the lower improvement in survival observed for adolescents and young adults (AYAs) (those aged 15-39 years) with cancer. This has been difficult to quantify without reliable mechanisms to link incident cases with study enrollments. Using unique resources available at their National Cancer Institute-designated comprehensive cancer center, the authors compared the percentage of AYAs, children, and older adults enrolled onto cancer clinical trials and determined predictors of enrollment.
  
  
  METHODS
  Patients diagnosed with cancer from January 2008 through December 2012 at 1 pediatric and 2 adult University of Southern California hospitals were identified through the California Cancer Registry and individually linked to institutional trial enrollment databases. The availability of clinical trials was assessed.
  
  
  RESULTS
  Across the center, the enrollment percentage for AYAs (6%) was equal to that of older adults (6%), but was less than that for children (22%) (P < .01). Within the children's hospital, the AYA enrollment percentage was also less than that for children (15% vs 23%, respectively; P<.01). On multivariate analysis, diagnosis and site of care were found to be predictive of AYA enrollment onto therapeutic and nontherapeutic studies. Hispanic and Asian/Pacific Islander individuals were more likely to enroll onto nontherapeutic studies compared with non-Hispanic whites, but no racial/ethnic difference was observed for therapeutic studies.
  
  
  CONCLUSIONS
  In the current study, the percentages of AYAs and older adults enrolled onto therapeutic trials were low but similar. Diagnosis, site of care, and race/ethnicity appear to be predictive of enrollment. Prospective mechanisms must be instituted to capture reasons for nonenrollment of AYAs and develop corrective interventions.
authors.affiliation: Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, California.
authors.forename: Chelsea L
authors.initials: CL
authors.lastname: Collins
authors.affiliation: Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California.
authors.forename: Jemily
authors.initials: J
authors.lastname: Malvar
authors.affiliation: Los Angeles Cancer Surveillance Program, University of Southern California Keck School of Medicine, Los Angeles, California.|Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, California.
authors.forename: Ann S
authors.initials: AS
authors.lastname: Hamilton
authors.affiliation: Los Angeles Cancer Surveillance Program, University of Southern California Keck School of Medicine, Los Angeles, California.|Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, California.
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Deapen
authors.affiliation: Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California.|Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, California.
authors.forename: David R
authors.initials: DR
authors.lastname: Freyer
mesh_terms: D000293:Adolescent; D000328:Adult; D001213:Asian / Q000706:statistics & numerical data; D002140:California; D002173:Cancer Care Facilities; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016247:Information Storage and Retrieval; D008297:Male; D054547:National Cancer Institute (U.S.); D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data; D009369:Neoplasms / Q000628:therapy*; D018579:Patient Selection; D012042:Registries; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
keywords: adolescent; clinical oncology; clinical trial as topic; young adult