Evidence map›Paper›PMID 39145378›Full record

ArticleAnnals of surgery2026

Underrepresentation of Racial and Ethnic Minorities in Metastatic Colorectal Carcinoma Clinical Trials Within the United States.

Tracey Pu, Alexandra Gustafson, Kenneth Luberice, Sarfraz R Akmal, Wei Li, Jonathan M Hernandez, Andrew M Blakely, Rebecca A Snyder, Oliver S Eng

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Global determinants of gynecologic cancer incidence and mortality: A cluster-based analysis with predictive insights.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Tracey PuSurgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD.ORCID 0000-0001-7880-2183
Alexandra GustafsonSurgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Kenneth LubericeSurgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Sarfraz R AkmalSurgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Wei LiDepartment of Biological Chemistry, Division of Computational Biomedicine, The University of California, Irvine, Orange, CA.
Jonathan M HernandezSurgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Andrew M BlakelySurgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Rebecca A SnyderDepartments of Surgical Oncology and Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX.
Oliver S EngDivision of Surgical Oncology, University of California, Irvine, Orange, CA.ORCID 0000-0003-0226-5005

Funding

Surgical Oncology Program Training ProgramZIEBC012097 · NCI · DIVISION OF BASIC SCIENCES - NCI · PI BLAKELY, ANDREW · 2022 to 2025
$17.3M
Intramural NIH HHS Z99 CA999999Intramural NIH HHS ZIE BC012097
6 · The paper itself

Abstract

objectiveTo investigate whether underrepresentation of racial and ethnic minorities exists in metastatic colorectal carcinoma (CRC) clinical trials.

backgroundRepresentation of vulnerable subpopulations is essential for the generalizability of clinical trials. Limited studies to date have investigated the racial and ethnic representation of patients enrolled in clinical trials for metastatic CRC.

methodsClinicalTrials.gov was queried for metastatic CRC clinical trials in the United States from 2000 to 2020. Incidence data were extracted from the SEER Database. Enrollment fraction was defined as the number of trial participants divided by U.S. incidence of metastatic CRC in each race, ethnicity, and sex. Representation quotient (RQ) was defined as the proportion of trial participants divided by the proportion of U.S. metastatic CRC incidence for each subgroup.

resultsA total of 8084 patients from 135 clinical trials were analyzed. Of clinical trials, 49.6% reported race data and 34.8% reported ethnicity data. Compared with 2000 to 2009, 2010 to 2019 had increased representation data reporting for race (61.2% vs 38.8%) and ethnicity (64.6% vs 35.4%). Of trials with race data, White patients represented 77.0%, Black patients 6.6%, Asian/Pacific Islander patients 16.1%, American Indian/Alaska Native patients 0.2%, and Hispanic patients 6.8%. Black patients (median RQ: 0.54), Asian/Pacific Islander patients (median RQ: 0.19), American Indian/Alaska Native patients (median RQ: 0.00), and Hispanic patients (median RQ: 0.26) were underrepresented. Black patients had a higher degree of underrepresentation in clinical trials with serum creatinine inclusion criteria (RQ: 0.40 vs 0.86, P = 0.034).

conclusionsStrategies are needed to increase minority enrollment in clinical trials for metastatic CRC. Identification of systemic barriers is integral in public policy advocacy to increase representation.

Indexed as

Clinical Trials as TopicColorectal NeoplasmsEthnic and Racial MinoritiesEthnicityMinority GroupsFemaleHumansMalePatient SelectionSEER ProgramUnited Statesclinical trialshealth equitymetastatic colorectal cancerracial representation

Identifiers

PMID39145378
PMCPMC13527745

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.