{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:19:01Z","timestamp":1791497941651,"version":"4.3.4"},"reference-count":90,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,12,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical trials (CTs) are essential for expanding treatment options across hematologic malignancies (HM) and providing access to novel treatments. However, older adults with HM are often underrepresented in CTs, and a national\u2010level evaluation of factors influencing their participation is lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors conducted a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER)\u2010Medicare database, identifying patients \u226566 years old diagnosed with HM between 2006 and 2018 (follow\u2010up to December 2019). CT participation was defined by Medicare claims for CT services. Cumulative incidence and Fine\u2010Gray models were used to estimate participation rates and adjusted hazard ratios (aHRs) assessed the association between participation and sociodemographic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a053,919) was 50% female, median age 78 years old, and 86% White. Cumulative incidence of CT participation was low at 2.7% at 1 year after diagnosis, increasing to 4.3% at 5 years. After adjustment for the competing risk of death, significantly lower CT participation was observed for older age (vs. 66\u201369 years: aHR for 70\u201374 years, 0.79 [95% CI, 0.71\u20130.88]; aHR for 75\u201379 years, 0.63 [95% CI, 0.56\u20130.70]; aHR for 80\u201384 years, 0.41 [95% CI, 0.36\u20130.46]; aHR for \u226585 years, 0.21 [95% CI, 0.18\u20130.24]), female sex (aHR, 0.79 [95% CI, 0.73\u20130.86]), Black race (aHR, 0.73 [95% CI, 0.59\u20130.90]), certain comorbidities (aHR for pulmonary disease, 0.76 [95% CI, 0.68\u20130.85]; aHR for renal disease, 0.67 [95% CI, 0.59\u20130.76]), dual Medicare\u2013Medicaid eligibility (aHR, 0.66 [95% CI, 0.56\u20130.77]), and distance to National Cancer Institute centers from the patient\u2019s ZIP code (aHR for \u2265250 miles, 0.64 [95% CI, 0.48\u20130.86]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results highlight the need for targeted interventions, such as CT navigator programs and decentralized trials, to increase older adult participation in HM CTs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70204","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T11:45:32Z","timestamp":1765367132000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Disparities in clinical trial participation among older adult Medicare beneficiaries with hematologic malignancies from 2006 to 2019: A SEER\u2013Medicare analysis"],"prefix":"10.1002","volume":"131","author":[{"given":"Inna Y.","family":"Gong","sequence":"first","affiliation":[{"name":"Department of Medical Oncology and Hematology Princess Margaret Cancer Centre  Toronto Ontario Canada"},{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Soto","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Harvard T. 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