Improving access to cancer clinical trials for patients from CALD backgrounds whose preferred language is not English - Results of a National Survey in Australia (Current Resources)

ABSTRACT

INTRODUCTION AND OBJECTIVES: Despite Australia having an extremely diverse population, research demonstrates that cancer patients from culturally and linguistically diverse ('CALD') communities are underrepresented in clinical trials. To inform future policy and strategy to address this inequity, we completed a national survey of the Australian clinical trials workforce evaluating current resources to address this issue, identified barriers and preferred solutions. This reports current resources in place. METHODS: An online survey was created using Redcap comprising a mix of 15 closed and open-ended items with an estimated completion time of 20 minutes. The survey was emailed to members of two peak bodies for oncology clinicians in Australia, the Clinical Oncology Society of Australia (COSA) and the Medical Oncology Group of Australia (MOGA) and all major cancer cooperative trial groups (12) in Australia. The survey was also promoted by the study team to relevant individuals and online via Twitter. Quantitative analysis was performed using Microsoft Excel and qualitative analysis of free text entries was performed using NVivo. RESULTS: 91 respondents completed the questionnaire, with representatives from each state - the majority of respondents were from NSW (53%) and Victoria (31%). 68% were clinicians and 16% were clinical trial coordinators. 55% of respondents reported that their trial catchment was comprised of over 20% patients from a CALD background - however, 62% reported that less than 20% of their trials had included CALD participants in the previous 12 months. 74% of respondents reported that their units do not routinely collect data on preferred language or ethnic background of trial patients. Qualitative analysis showed that the only resource routinely available to sites are in person interpreters used in standard of care, which additionally, have been difficult to access during the COVID pandemic leading to only phone interpreters. CONCLUSIONS: This representative survey of the Australian cancer clinical trials workforce confirms an ongoing inequity with disproportionately lower numbers of CALD patients on enrolled in cancer clinical trials compared to the catchments served. Most respondents stated that CALD data is not routinely collected, which inhibits ongoing monitoring of this issue. We did not find evidence of existing specific resources in place to support recruitment of CALD populations, apart from standard of care interpreters.