We are living longer, and our population is increasingly aging. Despite a growing need for clinical trials that benefit seniors, the median age of clinical trial participants is decreasing. A recent study examining clinical trial enrollment of over 262,000 patients with common cancer types between 1994 and 2015 found that the difference in the median age of trial participants was nearly 6.5 years younger than the median age of the affected population.
This age gap was even wider when exclusively examining industry-funded trials. Of note, these industry-funded trials are usually not government-affiliated and are thus not subject to government initiatives that might have pushed for more equitable inclusion. The study suggests that industry-funded trials might also occur in centers where younger patients are more likely to be treated, as there were no differences in the enrollment criteria between industry and government-funded trials [1].
While many clinical trials place upper age restrictions in their exclusion criteria, these restrictions do not appear to be responsible for the lack of elderly representation. More and more studies are removing age restrictions entirely. This lack of representation might be better explained by other barriers and social determinants of health, like exclusion due to comorbidities or a lack of access to transportation [2].
The paucity of literature on elderly participation in clinical trials underscores the importance of interventions to boost senior recruitment and enrollment. Until this age gap in clinical trials is addressed, our seniors remain at risk, unable to fully benefit from the latest medical advances.
Sources:
[1] Ludmir, E. B., Mainwaring, W., Lin, T. A., Miller, A. B., Jethanandani, A., Espinoza, A. F., Mandel, J. J., Lin, S. H., Smith, B. D., Smith, G. L., VanderWalde, N. A., Minsky, B. D., Koong, A. C., Stinchcombe, T. E., Jagsi, R., Gomez, D. R., Thomas, C. R., Jr, & Fuller, C. D. (2019). Factors Associated With Age Disparities Among Cancer Clinical Trial Participants. JAMA Oncology, 5(12). https://doi.org/10.1001/jamaoncol.2019.2055[2] Ludmir, E. B., Subbiah, I. M., Mainwaring, W., Miller, A. B., Lin, T. A., Jethanandani, A., Espinoza, A. F., Mandel, J. J., Fang, P., Smith, B. D., Smith, G. L., Pinnix, C. C., Sedrak, M. S., Kimmick, G. G., Stinchcombe, T. E., Jagsi, R., Thomas, C. R., Jr, Fuller, C. D., & VanderWalde, N. A. (2020). Decreasing incidence of upper age restriction enrollment criteria among cancer clinical trials. Journal of Geriatric Oncology, 11(3), 451–454. https://doi.org/10.1016/j.jgo.2019.11.001