{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:13:40Z","timestamp":1788286420477,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2019,3,22]],"date-time":"2019-03-22T00:00:00Z","timestamp":1553212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HHSN261201300020I"],"award-info":[{"award-number":["HHSN261201300020I"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30CA086862"],"award-info":[{"award-number":["P30CA086862"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cancer survival rates in adolescents and young adults (AYAs) have shown slow improvements in comparison with other age groups, and this may be due to lower participation in clinical trials. Little evidence has been provided regarding how nonmetropolitan residence may influence clinical trial enrollment for AYAs with cancer. This study sought to determine whether AYAs from nonmetropolitan areas have lower rates of clinical trial enrollment than their urban counterparts and to examine factors associated with enrollment variation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from the National Cancer Institute\u2019s 2006 and 2013 Surveillance, Epidemiology, and End Results Patterns of Care AYA cohorts were analyzed. Patients with acute lymphoblastic leukemia, Hodgkin lymphoma, non\u2010Hodgkin lymphoma, and sarcoma were included (n\u00a0=\u00a03155). Urban influence codes were used to measure the rurality of the county of residence at diagnosis, which was categorized as large metropolitan, small metropolitan, or nonmetropolitan. Logistic regression compared trial participants and nonparticipants while adjusting for patient and provider factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with AYAs from large metropolitan counties, AYAs from small metropolitan (odds ratio [OR], 2.04; 95% confidence interval [CI], 1.57\u20102.64) or nonmetropolitan counties (OR, 1.86; 95% CI, 1.23\u20102.81) experienced greater trial enrollment. AYAs treated at a hospital with a residency program (OR, 2.27; 95% CI, 1.63\u20103.16) or by a pediatric oncologist (OR, 4.02; 95% CI, 3.03\u20105.32) were associated with greater enrollment. There was a significant interaction between rurality and hospital size, which had the greatest impact on nonmetropolitan enrollment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinical trial enrollment was higher among AYAs from nonmetropolitan counties than those from metropolitan counties, predominantly when they were treated at large hospitals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.32038","type":"journal-article","created":{"date-parts":[[2019,3,22]],"date-time":"2019-03-22T12:00:12Z","timestamp":1553256012000},"page":"2283-2290","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Nonmetropolitan residence and other factors affecting clinical trial enrollment for adolescents and young adults with cancer in a US population\u2013based study"],"prefix":"10.1002","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6278-6593","authenticated-orcid":false,"given":"Erin M.","family":"Mobley","sequence":"first","affiliation":[{"name":"Department of Health Management and Policy, College of Public Health University of Iowa Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Charlton","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health University of Iowa Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia M.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy, College of Public Health University of Iowa Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles F.","family":"Lynch","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health University of Iowa Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,22]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Closing the Gap: Research and Care Imperatives for Adolescents and Young Adults With Cancer\u2014Report of the Adolescent and Young Adult Oncology Progress Review Group","author":"Adolescent and Young Adult Oncology Progress Review Group","year":"2006"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2009.05.001"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.36.2954"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e3181b91180"},{"key":"e_1_2_8_6_1","unstructured":"National Cancer Institute.Adolescents and young adults with cancer.https:\/\/www.cancer.gov\/types\/aya. Accessed November 8 2018."},{"key":"e_1_2_8_7_1","first-page":"633","article-title":"Challenges of rural cancer care in the US","volume":"29","author":"Charlton M","year":"2015","journal-title":"Oncology (Williston Park)"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.18.00149"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2013.001217"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25170"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2013.001191"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.08.056"},{"key":"e_1_2_8_13_1","unstructured":"National Cancer Institute.Patterns of Care studies.https:\/\/healthcaredelivery.cancer.gov\/poc\/. Accessed January 3 2018."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-0361.1997.tb00975.x"},{"key":"e_1_2_8_15_1","unstructured":"US Department of Agriculture.Urban influence codes.https:\/\/www.ers.usda.gov\/data-products\/urban-influence-codes\/. Accessed January 3 2018."},{"key":"e_1_2_8_16_1","unstructured":"US Department of Agriculture.Urban influence codes: documentation.https:\/\/www.ers.usda.gov\/data-products\/urban-influence-codes\/documentation\/. Accessed January 24 2018."},{"key":"e_1_2_8_17_1","unstructured":"YoungR JohnsonDR.To weight or not to weight that is the question: survey weights and multivariate analysis. Paper presented at: 67th Annual Conference of the American Association for Public Opinion Research; May 17\u201020 2012; Orlando FL."},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22102"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2010.04.002"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27426"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1054-139X(97)00110-9"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2017.12.006"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23229"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2010.000158"},{"key":"e_1_2_8_25_1","unstructured":"National Rural Health Association.About rural health care.https:\/\/www.ruralhealthweb.org\/about-nrha\/about-rural-health-care. Accessed November 5 2018."},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.14694\/EDBK_156686"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.32038","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.32038","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.32038","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.32038","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T01:05:44Z","timestamp":1761872744000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.32038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,22]]},"references-count":25,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1002\/cncr.32038"],"URL":"https:\/\/doi.org\/10.1002\/cncr.32038","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,22]]},"assertion":[{"value":"2018-11-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}