Rural–urban differences in discussions of cancer treatment clinical trials

Abstract 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.