Advancing Representation of LGBTQ+, Black Immigrant, and Rural Communities in Oncology Clinical Trials: Future Considerations.

Clinical trials play a major role in advances in cancer prevention, detection, treatment, and survivorship. However, clinical trials do not often include adequate representation from the populations most at risk for developing and dying from cancer, thus limiting the generalizability of trial findings. Gaining a better understanding of the barriers that limit representation in trials is essential to developing and testing interventions to overcome these barriers. This paper examines barriers to cancer clinical trial participation among LGBTQ+ people, Black immigrants, and people living in rural communities, and highlights promising strategies to advance improvements in cancer-related health outcomes for all populations. Drawing on proceedings from the 2024 Science of Community Outreach and Engagement (SoCOE) Conference, we propose actionable recommendations for embedding equity into clinical trial design, policy, and practice to ensure that all communities benefit from innovations in cancer care.