Analysis of racial demographic reporting in clinical studies supporting NCCN Small Cell Lung Cancer guidelines.

Abstract

e13784 Background: Racial and ethnic disparities in cancer care persist, with Black individuals facing higher lung cancer incidence (15%) and mortality rates (18%) compared to Whites, alongside a lower likelihood of early detection (16% vs. 20%) and access to curative therapies [CA Cancer J Clin 2019;69:211]. This underscores the need for equitable care and representation in research. The NCCN guidelines are critical for SCLC diagnosis and treatment, prompting an examination of racial demographic reporting in cited studies. Methods: We reviewed 311 references in the NCCN SCLC Guidelines Version 3, focusing on clinical studies while excluding reviews and non-clinical research. We assessed each study for racial demographics reporting, racial breakdowns, publication year, and geographic location. We analyzed racial representation trends over five decades (1980–2024), differentiating between U.S. and international studies. Results: 311 references were reviewed, and 208 were excluded based on the predetermined criteria above. Of the remaining 103 references, 31 (30.1%) clinical studies reported racial data. While the proportion of studies reporting race increased numerically from 15.2% (5/33) in 1980–1999 to 60.0% (9/15) in 2020–2024, Fisher’s exact test (p = 0.07) indicated that this rise was notstatistically significant, suggesting no clear increasing trend in race reporting over decades. U.S. studies reported race more frequently (20/34, 58.8%) than international studies (11/69, 15.9%). Many studies aggregating minorities into “non-White” categories did not provide distinct counts for Black or other underrepresented groups (see Table 1). Further, the Mann-Kendall trend analysis showed no significant decrease in the proportion of Whites over time (t-test score = -0.6; p > 0.05). Conclusions: Less than one-third of clinical studies in the NCCN SCLC guidelines report racial demographics. Although there was a numerical increase in reporting across the decades, this did not reach statistical significance, and there was also no significant decrease in the proportion of Whites reported. Reporting was more common in U.S. studies, but many still lack transparency regarding specific minority representation. These findings highlight the need for standardized race and ethnicity reporting in SCLC trials to ensure guidelines applyto all patients. SCLC clinical studies reporting race over time. Time Block White (%) Non-White (%) Black (%) Asian (%) American Indian/Alaska Native (%) Native Hawaiian/Pacific Islander (%) Hispanic (%) More than one race (%) 1980–1999 89.4 9.7 0.9 0.0 0.0 0.0 0.0 0.0 2000–2004 97.0 2.2 0.6 0.0 0.0 0.0 0.2 0.0 2005–2009 91.9 0.1 5.3 0.4 0.1 0.0 2.2 0.0 2010–2014 91.4 0.0 4.5 2.1 0.4 0.4 0.0 1.3 2015–2019 85.7 0.0 0.8 13.5 0.0 0.0 0.0 0.0 2020–2024 72.7 7.9 3.7 15.0 0.2 0.0 0.5 0.0 Total: 90.1 0.8 4.3 3.1 0.3 0.3 0.1 1.1