Quantification and optimization of travel time for ethnic minority populations in cancer clinical trials

ABSTRACT Of all minority racial and ethnic groups, Hispanic populations are most under-represented in trials compared to the general US population. Transportation and socioeconomic burdens are two important inter-related quantifiable and modifiable variables associated with decreased clinical trial participation for underrepresented populations. In this study, Hispanic population sizes and socioeconomic deprivation indices of catchment areas within simulated 30-minute driving distances from all major U.S. cancer trial sites (N=78) and all U.S. hospitals (N=7,623) were calculated using OpenStreetMap and U.S. census data. In the proximity of major trial sites Hispanic ethnicity representation varied across a wide range (64% to 2%) and Hispanic populations were underrepresented compared to the national average in almost 2/3 of the sites (n=50). The cities with the highest number of hospitals identified with catchment populations of >60%, >40% or >20% Hispanic representation were San Antonio TX, Houston TX, and New York NY respectively. Data-driven analyses can quantify and optimize measurable factors associated with decreased clinical trial participation for under-represented populations and may aid selection of trial sites to enable participation. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study did not receive any funding other than institutional support from Cold Spring Harbor Laboratory and Northwell Health. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present study are available upon reasonable request to the authors.