The mission of the Gender and Ethnic Diversity Committee is to improve the inclusion of women and minorities as subjects in clinical oncology research trials. In addition, we evaluate any scientific evidence of differences in either toxicity or response between the various patient populations served. The NCCTG has the highest accrual of American Indian patients to clinical trials of any cooperative group in the country. Until the recent inclusion of new NCCTG sites with geographic access to minority populations, we did not have significant numbers of Black, Hispanic, or Asian patients. That pattern is changing. The inclusion of Howard University in the NCCTG is a major opportunity to extend the benefits of our clinical trials research to the African American population. Historically, we have enrolled 4-5% minorities on NCCTG treatment trials overall. Our greatest success in enhanced accrual in the past few years has been within the cancer control trials, where in 1998 twenty-one (21%) of patients accrued to such trials were minority patients. In 1996, we developed a protocol to work with tribes to assess breast cancer risk factors and mammographic breast density in American Indian women. The Network for Cancer Control Research among American Indian and Alaska Native Populations is a co-sponsor of the study. The initial research was conducted in North and South Dakota at NCCTG sites and then expanded to 21 tribes served by the Inter-Tribal Council of Arizona and the Phoenix Indian Medical Center. In 1998, the Alaska Native Medical Center invited us to extend participation to their site. Another research protocol seeks to measure a selected panel of molecular markers in American Indian/Alaska Native breast cancer patients who were treated in the Aberdeen, Phoenix, or Alaska areas of the Indian Health Service. We will determine which (if any) molecular markers provide independent prognostic information in this group and compare them to matched Caucasian patients previously analyzed on NCCTG protocol 77-30-51. This type of study can yield unique insights into our understanding of whether poorer survival is stage-dependent only or linked to basic molecular marker profiling. Future plans include: designation from each NCCTG site of a person with skills, communication channels/contacts with special populations in their area, planning for trials to include a resource component that specifically enhances minority accrual; inclusion for patient advocates on the committee, collaboration with the corollary ECOG committee, development and distribution of cultural specific and sensitive materials for enhancement of patient awareness and interest in clinical trials through the NCCTG, publication of our initial experiences with addressing the barriers to clinical trial participation for minority patients; enhanced strategies for increasing accrual to treatment trials, and efforts to reduce the racial discrimination for patients entering trials from """"""""other or unknown"""""""" categories (goal: <3% all disease sites).
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