Remove blanket exclusions for mental illness and dementia; support consent instead
People with serious mental illness or dementia are routinely excluded from cancer trials, though they get cancer just as often and do worse. Supported consent and reasonable accommodations would let many take part.
Protocols replace 'psychiatric illness that would interfere with compliance' and similar clauses with specific, assessable criteria; supported decision-making, legally authorised representative consent where appropriate, and accommodations (longer visits, carer involvement, simplified materials) are funded. Enrolment and outcomes for these groups are reported.
- Trials do not represent the people who get cancer · Older, Black, Hispanic, Asian, rural, poor and multimorbid patients are under-represented, so results may not apply to them.
- Trials enrol too few, too slowly · Fewer than one in ten adults with cancer joins a trial. Trials close for lack of patients, not lack of ideas.
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not linked directly; found by shared links- IdeaCommunity health workers and trusted local organisations paid to recruit for trials
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly, National Cancer Institute (NIH).
- IdeaAt least a third of pivotal-trial sites in community and rural settings
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly, National Cancer Institute (NIH).
- IdeaMobile research units bring trial visits to rural towns
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly, National Cancer Institute (NIH).
- IdeaLay trial navigators funded per centre, evaluated in a randomised trial
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly, National Cancer Institute (NIH).
- IdeaStop excluding people with a prior cancer, controlled HIV, or treated hepatitis
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly, National Cancer Institute (NIH).
- IdeaPay trial participants for their time, not only their expenses
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly.
- IdeaTravel, lodging and meals reimbursed as a standard line in every trial budget
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly.
- IdeaPaid community advisory boards with power to change protocol burden
Shares Trials do not represent the people who get cancer, National Cancer Institute (NIH).