An Evaluation of Barriers to Accrual in the Era of Legislation Requiring Insurance Coverage of Cancer Clinical Trial Costs in California.

The article discusses clinical trial accrual. Remarkable advances in the treatment of cancer have been made over the past years. These improvements result from a combination of advances in the basic sciences, pharmaceuticals, radiation and surgery. There is little question that performance of a clinical trial, always difficult, has become considerably more arduous in the past few years. A number of reasons, including increased complexity, more stringent entry criteria and increased regulatory oversight have been cited for few patients actually enrolling on trials. Cancer clinical trials are essential to the development of new therapies and to improving patient outcomes. However, the rates of enrollment of patients with cancer to clinical trials remain dismally low, despite the fact that cancer patients and the public seem to have generally positive attitudes toward cancer research.