"It's a reasonable gamble" — rural residents' experience participating in cancer clinical trials at a single rural trial unit

Journal article


McPhee, Narelle J., Hughes, Diane and Ristevski, Eli. (2025). "It's a reasonable gamble" — rural residents' experience participating in cancer clinical trials at a single rural trial unit. Trials. 26(1), p. Article 67. https://doi.org/10.1186/s13063-025-08731-y
AuthorsMcPhee, Narelle J., Hughes, Diane and Ristevski, Eli
Abstract

Background
We conducted a qualitative study to examine what factors influence rural-residing people with cancer to participate in cancer clinical trials (CCT) and what factors influence their retention in CCT.

Methods
Purposive sampling was used to recruit participants from a regional cancer centre in Victoria, Australia, to participate in a semi-structured interview. Eligible participants were ≥ 18 years of age at the time of cancer diagnosis, newly consented to a clinical trial (< 1 year) or have been a trial participant for ≥ 1 year, lived in a non-metropolitan area classified within the Monash Modified (MM) Model 2–7 and able to provide informed consent. Thematic analysis was used to analyse the interview data.

Results
Seventeen participants were interviewed; 10 identified as female and seven as male. Participant’s ages ranged from 52 to 77 years, with a median age of 62 years. Eight participants had been on a CCT for ≤ 1 and 10 for ≥ 1 year. Factors that influenced their decision to participate in a CCT included trust and confidence in clinical trial staff, exposure to and trust in the experiences of cancer peers, altruism, low-risk trials and local access to trials. The factors influencing their decision to remain in a CCT included balancing the benefits and burdens of the trial, having no doubts about participating despite knowing the risks and seeing the personal benefits of participating in a CCT.

Conclusion
Our study shows that trust-based relationships, peer support, and altruism encourage rural residents to participate in CCT. To improve access to CCT for rural residents, a multi-faceted approach involving clinicians, health services, trial sponsors and policymakers is needed. These approaches must promote and facilitate the inclusion of diverse populations, prioritise CCT participation, and inform patients of CCT opportunities. We must recognise the knowledge and expertise of rural patients and caregivers and ensure they are involved as co-designers of future CCTs.

Keywordscancer clinical trials; rural health; equity; access
Year2025
JournalTrials
Journal citation26 (1), p. Article 67
PublisherBiomed Central Ltd
ISSN1745-6215
Digital Object Identifier (DOI)https://doi.org/10.1186/s13063-025-08731-y
PubMed ID39994805
Scopus EID2-s2.0-85218694051
PubMed Central IDPMC11852551
Open accessPublished as ‘gold’ (paid) open access
Page range1-10
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online25 Feb 2025
Publication process dates
Accepted14 Jan 2025
Deposited05 Jun 2025
Additional information

© The Author(s) 2025.

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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