美国在提供和获取神经肿瘤学试验支持基础设施方面的差距

Yeonju Kim, Terri S Armstrong, Mark R Gilbert, Orieta Celiku
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摘要

我们对美国肿瘤临床试验支持基础设施的覆盖范围进行了广泛的评估和量化。虽然我们的主要重点是确定扩大神经肿瘤临床试验覆盖范围的途径,但我们也考虑了对更广泛的癌症研究和治疗具有重要影响的基础设施层次。具体来说,我们考察了全国性合作机构(包括 1,500 多家机构)、600 多个肿瘤学和神经外科学术培训项目以及由 25,000 多名神经肿瘤学、神经外科和普通肿瘤学(包括血液学/医学/妇科肿瘤学、肿瘤外科和肿瘤放射学)医疗服务提供者组成的网络在地理、人口和社会经济方面的覆盖范围。我们的研究发现,超过 57% 的美国人口无法直接使用支持试验的基础设施。71%以上拥有基础设施的地点位于城市,72%以上位于社会经济条件较好的地区。我们的研究结果揭示了在肿瘤治疗方面存在的严重差距,并提出了优化和扩大现有基础设施覆盖范围的可行策略。
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Disparities in the availability and access to Neuro-Oncology Trial-Supporting infrastructure in the United States
We conducted an extensive assessment and quantification of the reach of the oncology clinical trial supporting infrastructure in the United States (US). While our primary focus was on identifying avenues to expand the reach of neuro-oncology clinical trials, we considered infrastructure layers with important implications for broader cancer research and care. Specifically, we examined the geographic, population, and socioeconomic reach of national collaboratives (including over 1,500 institutions), over 600 academic oncology and neurosurgery training programs, and networks of over 25,000 individual neuro-oncology, neurosurgery, and general oncology (including hematology/medical/gynecological oncology, surgical oncology, and radiation oncology) providers. Our study found that over 57% of the US population lacks direct access to trial-supporting infrastructure. More than 71% of the locations with infrastructure are urban, and over 72% are in socioeconomically-advantaged areas. Our findings reveal critical disparities in oncology care access and suggest actionable strategies to optimize and expand the existing infrastructure’s reach.\
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