Abstract C098: Analysis of disparities in access to modern cancer therapies based on the place of residence (rural/urban) of participants

Background According to the Polish National Cancer Registry, approximately 1.3 million people in Poland are currently living with cancer. The Pomeranian Voivodeship, with a population of around 2.36 million (59% urban and 41% rural residents), spans 18,323 square kilometers and reports one of the highest cancer incidence rates in the country—an estimated 10,474 new cancer cases are diagnosed annually. A significant portion of the population remains professionally active. Study Aim This study aimed to evaluate disparities in access to oncological clinical trials based on gender, age, and place of residence (urban vs. rural). Methods We conducted a retrospective analysis of medical records for all patients over the age of 18 who were enrolled in oncological clinical trials between January 2024 and December 2025 at a single tertiary oncology center: the Department of Oncology and Radiotherapy, University Clinical Center in Gdansk. Patient data were anonymized and extracted from medical records. The study was approved by local ethics authorities and conducted in accordance with the latest version of the Declaration of Helsinki. All participants provided informed consent prior to inclusion. Statistical Analysis Descriptive statistics and chi-square tests were used to analyze demographic variables and assess differences between groups. Results A total of 148 patients (aged 20 to 85 years) with various oncological diagnoses were enrolled and treated within clinical trials during the study period. The study group included 80 women (54%) aged 27 to 89 years, median age 61,5 and 68 men (46%) aged 34 to 86 years, median age 69. Most participants were from urban areas (107 patients, 72%), while only 41 patients (28%) resided in rural areas. Among women over 64 years of age, 42% lived in urban areas compared to only 24% from rural areas. Among men, 81% of rural participants were older than 65, compared to 67% of their urban counterparts. Male residents of rural areas older than 64 years significantly less commonly participated in oncological clinical trials (p < 0.05). Conclusion The study demonstrates a clear predominance of urban residents among participants in oncological clinical trials, indicating a disparity in access for rural populations. Contributing factors likely include limited mobility among older individuals, transportation and logistical challenges, and lower awareness or understanding of clinical trial opportunities in rural communities. Moreover, these disparities appear to intersect with broader socioeconomic inequalities, further restricting access to innovative cancer treatments for rural residents. To address these inequities, targeted educational campaigns and information dissemination are essential. Additionally, expanding local research infrastructure and providing logistical support, particularly for older adults in rural areas are critical steps to ensure equitable access to modern oncological therapies. Citation Format: Izabela Gudewicz, Renata Zaucha. Analysis of disparities in access to modern cancer therapies based on the place of residence (rural/urban) of participants [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C098.