As the development in cancer diagnosis and cancer treatment progresses and becomes more specific, the need for properly designed clinical trials will increase dramatically. Robert Finn's report on clinical trials1 discussed the barriers to participation, particularly low level of public interest and economic cost. There are a number of other barriers, and these will only be systematically corrected if the whole basis of these trials is reevaluated to include demographic and economic considerations. At this time, trials are still gender biased and minorities, particularly African Americans and Hispanics, are excluded. Similarly, poor people, rural residents, and small-town populations are underrepresented. This is not only a matter of equity, since taxpayers' moneys pay for much of the program, but it may result in the loss of valuable epidemiological data related to variations in effectiveness.

Robert Rutman, Ph.D.
Emeritus Professor, Molecular Biology
University of Pennsylvania
Philadelphia, PA

1. R. Finn, "Breaking...

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