When it comes to deciding whether to participate in clinical cancer trials, money matters most, reports a recent study published in the Journal of the National Comprehensive Cancer Network (JNCCN).

“Financial factors—particularly income and property ownership—were the strongest predictors of trial participation, after adjusting for age, sex, cancer type and year of diagnosis,” wrote the study’s authors. “This highlights the critical role that financial stability plays in accessing advanced treatment options.”

Cancer patients who participate in clinical trials benefit from innovative therapies, treatment monitoring, improved health outcomes and the possibility of living much longer lives. But enrollment rates, especially among racial and ethnic minorities, depend on participants’ ability to overcome financial barriers that hinder access.

For the study, researchers reviewed the electronic medical records of almost 13,000 patients ages 18 to 75 who were diagnosed with primary cancer between 2018 and 2021 at University Hospitals, a regional system in Northeast Ohio.

Individuals who died within six months of their diagnosis were excluded as were uninsured patients, those with military-sponsored insurance and people missing follow-up records.

The medical data included information about each patient’s income, education, housing stability, social support and other socioeconomic factors and identified them by their social security number, date of birth, biological sex, state, age at diagnosis, cancer type, race and ethnicity, health insurance and how long it took individuals to drive to the trial site at University Hospitals.

Of these patients, 649 (about 5%) participated in a clinical trial for cancer treatment.

Using a machine learning algorithm to analyze the data, scientists identified key predictors of trial enrollment, and financial factors topped the list.

“Our findings suggest that addressing financial barriers may represent the most impactful strategy for researchers and policymakers seeking to increase and normalize clinical trial enrollment across all patients with cancer,” said lead study author Weichuan Dong, PhD, an assistant professor at Case Western Reserve University’s School of Medicine.

Dong suggested that out-of-pocket costs for clinical trials can be deal-breakers for patients. But scientists found that when patients were reimbursed for certain indirect costs, such as travel and lodging expenses and lost wages, and provided with transportation vouchers and expanded caregiver support services, trial enrollment improved.

To learn more about the role of clinical trials in cancer research, read “Understanding Clinical Trials in Cancer Care” and “Cancer Clinical Trials Go Remote, Improving Access and Accrual.”