The Persistence of Racial Representation Disparity in Head and Neck Cancer Clinical Trials in the United States: A Temporal Analysis of 20 Years of Data

BACKGROUND: Significant racial disparities in survival outcomes exist among Head and Neck Cancer (HNC) patients. Building upon Zuckerman et al., this current study assessed temporal changes in HNC clinical trial enrollment in the context of changing racial/ethnic disease prevalence. METHODS: One hundred seven eligible HNC clinical trials were analyzed from 2002 to 2020. Participant demographics were categorized into five standardized racial/ethnic groups aligned with SEER database classifications. Differences in racial group enrollment rates were investigated using boxplots and scatterplots stratified by race and year, and with multiple linear regression. RESULTS: White participants were overrepresented and minority groups were consistently underrepresented: Black (-0.121, 95% CI: [-0.145, -0.095]), Hispanic (-0.174, 95% CI: [-0.199, -0.149]), Asian/Pacific Islander (-0.129, 95% CI: [-0.155, -0.105]), and American Indian/Alaska Native (-0.104, 95% CI: [-0.128, -0.079]). CONCLUSION: Collectively, this data supports the need for new approaches that facilitate equitable representation, needed to improve HNC treatment outcomes across all demographic groups.