Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Cultural diversity in Australian cancer clinical trials: how well do we capture our population? (126748)

Gowri Shivasabesan 1 2 , Vikneswary Batumalai 3 4 , Abhijit Pal 5 6 , Wei Chua 5 6 , Md Mijanur Rahman 4 7 , Siphiwe Ratladi 4 , Fiona Stanaway 8 , Mei Ling Yap 3 4 9 10
  1. Prince of Wales Hospital, Randwick, NSW, Australia
  2. School of Clinical Medicine, UNSW Sydney, Sydney, NSW, Australia
  3. The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
  4. The Collaboration for Cancer Outcomes, Research and Evaluation (CCORE), Ingham Institute, UNSW Sydney, Sydney, NSW, Australia
  5. Department of Medical Oncology, Liverpool Hospital, Sydney, NSW, Australia
  6. School of Medicine, Western Sydney University, Sydney, NSW, Australia
  7. The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW, Australia
  8. Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney NSW 2006, Australia, NSW, Australia
  9. Liverpool Cancer Therapy Centre, Sydney, NSW, Australia
  10. Macarthur Cancer Therapy Centre, Sydney, NSW, Australia

Objective: In Australia, more than 1 in 4 people are born overseas. Many speak a language other than English at home and 3% do not speak English well or at all. Patients from culturally and linguistically diverse (CALD) backgrounds have poorer cancer outcomes, and it is critical that they are included in trials to improve care. International studies in both cancer and non-cancer clinical trials have highlighted suboptimal race/ethnicity reporting and representation. This study assesses whether Australian cancer clinical trials report on such cultural diversity.

Methods: A systematic search of Embase was conducted to identify peer-reviewed articles published between 2014 and 2024, focusing on any adult cancer-related randomised controlled trials. Eligible studies were either predominantly conducted in Australia or led by Australian investigators. The reporting of cultural variables - including ethnicity, language spoken, and country of birth - was analysed.

Results: Of 629 articles screened, 238 met inclusion criteria. Most trials did not report whether participants were from CALD backgrounds. Only 18% (n=42) specifically reported on ethnicity/race with “Caucasian” and “Asian” most reported. An additional 14% (n=33) reported country of birth (typically Australia vs other), and 9% (n=22) reported whether English was the participants’ main language. There was no improvement on reporting of ethnicity or country of birth between studies from 2015-2019 vs 2019-2024 (32% vs 31%).

Conclusion and implications: The majority of Australian cancer clinical trials do not report, and likely do not collect, data on the inclusion of patients from CALD backgrounds. Improved reporting is essential to quantify engagement, increase recruitment, and ensure trial results are generalisable to diverse populations. To address disparities in cancer outcomes, we advocate that Australian cancer clinical trials should report a minimum required dataset of cultural demographic data (including ethnicity and language spoken) to improve cancer care for all.