Exploring Clinical Trial Barriers in Food Deserts: A Study of Breast Cancer Patients

A study presented by Mariam Eskander, MD, MPH, surgical oncologist and assistant professor of Surgery at the Rutgers Cancer Institute of New Jersey, at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting investigated how living in a food desert affects breast cancer clinical trial enrollment, considering the additional impact of transportation challenges and distance to trial sites. Researchers analyzed data from over 1.3 million patients with breast cancer treated between January 2022 and June 2024. They found that patients in food deserts, defined as areas with limited access to healthy food, had lower rates of clinical trial participation.

The study identified several key factors independently associated with decreased odds of trial enrollment: living in a food desert, residing in a "clinical trial desert" (over 2 hours' drive to a trial-enrolling hospital), and having limited access to transportation. Patients with Medicaid insurance also had reduced odds of enrollment, while those treated at academic hospitals were more likely to participate. Critically, the negative impact of living in a food desert was compounded when patients also lived in a clinical trial desert, resulting in a 27% lower likelihood of trial participation compared to a 19% reduction for food desert residents alone.

"There's a compounding effect of living in a double desert environment," said Eskander in an interview with Targeted Oncology^TM.

These findings underscore the complex barriers faced by disadvantaged populations and suggest that interventions like patient navigation, local food banks, and expanding clinical trial access in underserved communities could help improve enrollment.

REFERENCE:

Sachs R, Pamen L, Perati SR, et al. From food deserts to clinical trial deserts: Challenges in access to breast cancer trials. J Clin Oncol. 43, 1525-1525(2025).DOI:10.1200/JCO.2025.43.16_suppl.1525