临床试验
心理干预
医学
人口
癌症
老年学
干预(咨询)
老年肿瘤学
替代医学
随机对照试验
梅德林
家庭医学
环境卫生
护理部
病理
内科学
法学
政治学
作者
Mina S. Sedrak,Rachel A. Freedman,Harvey Jay Cohen,Hyman B. Muss,Aminah Jatoi,Heidi D. Klepin,Tanya M. Wildes,Jennifer Le‐Rademacher,Gretchen Kimmick,William P. Tew,Kevin George,Simran Padam,Jennifer Liu,Andrew R. Wong,Andrea Lynch,Benjamin Djulbegović,Supriya G. Mohile,William Dale
摘要
Abstract Cancer is a disease of aging and, as the world's population ages, the number of older persons with cancer is increasing and will make up a growing share of the oncology population in virtually every country. Despite this, older patients remain vastly underrepresented in research that sets the standards for cancer treatments. Consequently, most of what we know about cancer therapeutics is based on clinical trials conducted in younger, healthier patients, and effective strategies to improve clinical trial participation of older adults with cancer remain sparse. For this systematic review, the authors evaluated published studies regarding barriers to participation and interventions to improve participation of older adults in cancer trials. The quality of the available evidence was low and, despite a literature describing multifaceted barriers, only one intervention study aimed to increase enrollment of older adults in trials. The findings starkly amplify the paucity of evidence‐based, effective strategies to improve participation of this underrepresented population in cancer trials. Within these limitations, the authors provide their opinion on how the current cancer research infrastructure must be modified to accommodate the needs of older patients. Several underused solutions are offered to expand clinical trials to include older adults with cancer. However, as currently constructed, these recommendations alone will not solve the evidence gap in geriatric oncology, and efforts are needed to meet older and frail adults where they are by expanding clinical trials designed specifically for this population and leveraging real‐world data.
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