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This pilot study at Penn State Cancer Institute (PSCI) assessed the feasibility of a 14-question survey to identify barriers and motivations for clinical trial participation among 100 cancer patients, with a significant proportion having breast cancer. The survey achieved an 82.2% participation rate and identified "having several health issues" and "transportation cost or difficulties" as the most common concerns. Higher annual household income and previous trial participation were associated with increased willingness to participate in future trials.
A brief survey can effectively identify patient-reported barriers to clinical trial participation at tertiary cancer centers, highlighting the importance of addressing health issues and transportation costs.
Financial Strain and limited geographic access to tertiary treatment centers are known barriers to cancer clinical trial participation. A study conducted by Sydney Kimmel Cancer Center (SKCC) surveyed 2,744 adult residents in the Mid-Atlantic region, assessing their motivations and barriers to enter clinical trials and highlighting unique characteristics of their catchment area. Furthermore, this study proved useful to inform the development of targeted interventions and programs aimed at lowering barriers to participation. Therefore, a pilot study to explore the feasibility of conducting such a survey at Penn State Cancer Institute (PSCI), within its unique population that includes rural population as well as suburban ones was performed. This survey examined the motivation and specific barriers that PSCI’s patients face in relation to taking part in clinical trials. We conducted a pilot study of 100 patients(pts) at PSCI using a 14-questions paper survey exploring patients’ demographics, attitudes toward clinical trials, and their motivations and perceived barriers to future participation. Patients were also asked to rank their most significant concerns. 100 consecutive pts were surveyed, significant proportion of patients had breast cancer diagnosis. Association between demographic data and willingness to participate in trials were evaluated with Fisher’s exact test and corrected for false discovery rate with Benjamini-Hochberg procedure. The survey was completed by 100 pts within 3 business days, achieving an 82.2% participation rate. Data collection was managed by only 2 medical students, highlighting the high feasibility of this questionnaire to capture patients’ insights into trial participation. Median age was within 65-74 yrs and were 56% women, 88% white. Motivational findings were consistent with those reported by SKCC. (See Table 1) When asked about concerns preventing participation, the most commonly cited and ranked concerns was “having several health issues” (n=45), followed by “transportation cost or difficulties” (n=40). 100% pts reporting an annual household income (ahi) higher than $150k (n=10) expressed willingness to participate in trials, compared to 56% of ahi less than $150k (n=73, statistically significant (p=0.017)). Previous participation in trial was also associated with willingness to participate (p=0.018). We showed that this 14-questions survey exhibits high feasibility for capturing patient-reported barriers and motivations for clinical trial participation. Results were reproducible between 2 neighboring cancer treatment centers. Expanded studies are required to capture larger patient populations and demonstrate the survey potential at rural/suburban tertiary centers to support the design of further targeted interventions. A.-L. Strong, E. Wilson, M. Vasekar. I. C. Schultz, J. L. da Silva, L. Landeiro, N. C. Nunes, R. Sant’Ana, G. Onzi, N. Viana [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr XXX.
