Barriers and Human Support Shape Cancer Clinical Trial Access

Low enrollment in cancer clinical trials in the United States has drawn attention to the role of human support and navigation services in improving patient access and participation.

Participation rates for cancer clinical trials in the US typically range from 5% to 8%, with community centers seeing around 6% and academic centers reporting up to 15%. Multiple barriers affect these rates, including provider limitations, eligibility requirements, communication gaps, financial and logistical challenges, health literacy issues, and mistrust.

Navigation services led by nurses have been introduced to address these challenges. The Leukemia & Lymphoma Society’s Clinical Trial Support Center, which offers free telephone-based nurse navigation, reported nearly 30% enrollment among surveyed blood cancer patients or their caregivers following support from the service.

Other national nurse navigator-led programs for blood cancer patients have also reported increased enrollment. One such program documented an overall enrollment rate of 16.1%, with a higher rate of 22.5% among cases where outcomes were known.

What the numbers show

• US cancer clinical trial participation averages 5–8%
• Community centers report around 6% participation, academic centers about 15%
• Nurse navigator programs have achieved up to 30% enrollment rates

In Dallas, a patient navigation initiative within a safety-net healthcare system doubled the number of patients enrolling in cancer clinical trials in its first year, increasing from 36 to 78 participants. These figures suggest that navigation programs can contribute to higher enrollment in clinical research, especially in settings serving diverse populations.

The President’s Cancer Panel stated in late 2023 that technology should be used to complement, not replace, human interaction in patient navigation. The panel also indicated that access to technology should not be a prerequisite for equitable care in clinical trial participation.

Panelists at the SCOPE Summit emphasized the importance of expanding support beyond artificial intelligence tools. They highlighted the need for real human assistance, patient navigation, education, and professional networking to improve access to clinical trials.

Barriers to participation remain multifaceted, but evidence from navigation programs and institutional recommendations points to the value of combining human support with technology to address gaps in clinical trial access for cancer patients.

* This article is based on publicly available information at the time of writing.