Improving recruitment to clinical trials for regional and rural cancer patients through a regionally based clinical trials network

Abstract

In general, regional and rural patients have poorer cancer outcomes compared with their city counterparts.1 Although one-third of the Australian population live in rural and regional areas, there is ongoing inequity in access to care among regional Australians.2 Over the decade to 2010, the disparity in cancer outcomes between rural and urban patients remained unchanged with 7% excess mortality (equating to about 9000 additional rural deaths).3, 4 Until recently, clinical trials were almost exclusively conducted in metropolitan health institutions. Although a gateway to new treatments that can result in improved survival, clinical trials may be out of reach for many regional and rural cancer patients owing to distance.2, 5-10 In 2016, the rate of cancer trial participation was 6.7% in metropolitan Melbourne, but only 1.2% in regional Victoria.4 In that year, a total of 443 patients from regional Victoria accessed clinical cancer trials, but 343 of those regional patients travelled to Melbourne to access a trial.4 We postulate that low rates of trial participation may be a contributing factor to lower cancer 5-year survival in regional Victoria (66% compared with 70% in metropolitan Melbourne).4