Improving Access for Black Women in Breast Cancer Clinical Trials: An Exploration into Opportunities at Community Cancer Centers

Breast cancer is the second most common cancer among women in the United States (CDC,2024). Mortality rates for breast cancer are declining, but not equally for all populations. “Black women are 41% more likely to die from breast cancer than White women, despite having similar or lower incidence rates” (American Cancer Society, 2022). There are intersecting and compounding reasons for higher mortality rates in Black women. Evidence shows that a lack of access to high-quality care, (American Cancer Society, 2022), implicit biases of health care providers (Hall et al., 2015), and Black women presenting with more aggressive and late-stage forms of the disease (Uscher, 2023), are key drivers. Barriers to access to high-quality care result from a lack of insurance, reliable transportation, available healthcare providers or facilities, outreach about available healthcare services, and culturally competent care. Inadequate access to care leads to missed opportunities in preventative care, delayed diagnoses, and increases in deaths from treatable diseases like breast cancer. In addition, Black women are underrepresented in cancer clinical trials, a critical aspect of access to quality care. A cancer patient’s participation in clinical trials increases their access to innovative treatments, cutting-edge medications, and additional clinical care for the disease. Research has repeatedly shown that partaking in clinical trials improves patient outcomes, including survival (Taye A et al., 2024). Currently, Black women account for 3% or less of participants in breast cancer clinical trials (Stringer-Reasor et al., 2021), although a recent survey indicated that 83% of Black women with breast cancer would likely consider clinical trial participation (Cavallo, 2022). One driver of this disparity is community access to clinical trials for breast cancer. Most cancer patients, including Black women, receive care in community settings, not at academic medical centers where clinical trials usually take place (NCI, 2017). In addition, a recent survey of over 500 Black women indicated that a leading barrier to their participation in clinical research is that trial sites are too far (GCI Health, 2024). This finding confirms research by Riggan et al. (2023) which argues that “physically centering research activities in Black communities” could greatly improve recruitment and retention of Black participants in clinical trials. Conducting clinical trials at community cancer centers is an effective way to offer access to clinical research to marginalized populations, but the availability of trials in this practice setting is limited (Ebrahimi et al., 2024). For this reason, there is a need to identify opportunities to improve access to clinical trials at community cancer centers. The increased access to clinical trials in communities where Black women receive their breast cancer treatment can help work towards the equitable inclusion of Black women in breast cancer clinical research.