Rural-urban differences in discussions of cancer treatment clinical trials

Objective: Compare the characteristics of rural and urban callers to NCI's Cancer Information Service (CIS), and explore the association of geographic location and discussion of cancer clinical trials. Methods: Using CIS call data from 2006 to 2008, we assigned a rural or urban designation to caller ZIP codes using Rural-Urban Commuting Area Codes. Calls which discussed clinical trials were analyzed using univariate and multivariate analyses. Results: The CIS received 227,579 calls from 2006 to 2008 where geographic location could be determined. Overall, 10.3% of calls included a discussion of clinical trials; there were significantly more discussions among urban dwellers than rural individuals (10.5% versus 9.4%, respectively). Multivariate regression analyses supported the univariate findings. In addition, compared to other callers, patients (OR 5.58 [95% CI: 4.88, 6.39]) and family and friends (6.26 [5.48, 71.5]) were significantly more likely to discuss clinical trials. Conclusion: Urban callers were more likely than their rural counterparts to discuss cancer treatment trials, placing individuals living in rural areas at a disadvantage in learning about and communicating with their providers about possible participation in clinical trials. Practice implications: Through its multiple access points, the CIS can serve as an important source of clinical trials information for rural cancer patients, family members, and providers.