{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:21:18Z","timestamp":1791246078995,"version":"4.1.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"National Cancer Institute Training","award":["T32-CA-236621"],"award-info":[{"award-number":["T32-CA-236621"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Prostate cancer is marked by vast disparities in clinical outcomes for minoritized and socioeconomically disadvantaged populations. We aimed to evaluate the geographic distribution of prostate cancer clinical trial opportunities relative to prostate cancer mortality and social determinants of health by performing an ecological analysis of linked county-level prostate cancer clinical trial data, epidemiologic data, and the Centers for Disease Control and Prevention Social Vulnerability Index. On analysis of 1575 counties in the United States with available data, increasing Social Vulnerability Index was associated with an increase in prostate cancer mortality (+17.88, 95% confidence interval [CI] = 14.16 to 21.61; P\u2009&amp;lt;\u2009.001), lower odds of having any trial (odds ratio [OR] = 0.14, 95% CI = 0.09 to 0.23; P\u2009&amp;lt;\u2009.001), and fewer population-adjusted trials (incidence rate ratio = 0.27, 95% CI = 0.19 to 0.40; P\u2009&amp;lt;\u2009.001). Identifying communities experiencing adverse social determinants of health for expansion of clinical trial opportunities and mitigation of barriers may be an impactful strategy toward improving equity in clinical trials and cancer care.<\/jats:p>","DOI":"10.1093\/jnci\/djaf047","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T16:01:41Z","timestamp":1741104101000},"page":"1934-1937","source":"Crossref","is-referenced-by-count":3,"title":["Structural inequities in the availability of prostate cancer clinical trial opportunities"],"prefix":"10.1093","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6023-1722","authenticated-orcid":false,"given":"Rishi Robert","family":"Sekar","sequence":"first","affiliation":[{"name":"Department of Urology, University of Michigan , Ann Arbor, MI 48109,","place":["United States"]},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan , Ann Arbor, MI 48109,","place":["United States"]},{"name":"National Clinician Scholars Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6044-6563","authenticated-orcid":false,"given":"Laura","family":"Zebib","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California San Francisco , San Francisco, CA 94143,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3765-3393","authenticated-orcid":false,"given":"Kristian Donald","family":"Stensland","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Michigan , Ann Arbor, MI 48109,","place":["United States"]},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan , Ann Arbor, MI 48109,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey Allison","family":"Herrel","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Michigan , Ann Arbor, MI 48109,","place":["United States"]},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan , Ann Arbor, MI 48109,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"2025090809173153300_djaf047-B1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3322\/caac.21820","article-title":"Cancer statistics, 2024 [published correction appears in CA Cancer J Clin. 2024 Mar-Apr; 74(2):203]","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"2025090809173153300_djaf047-B2","doi-asserted-by":"publisher","first-page":"3787","DOI":"10.1002\/cncr.34433","article-title":"Racial disparities in Black men with prostate cancer: a literature review","volume":"128","author":"Lillard","year":"2022","journal-title":"Cancer"},{"key":"2025090809173153300_djaf047-B3","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1200\/OP.23.00040","article-title":"Disparities in diagnosis, treatment access, and time to treatment among Hispanic men with metastatic prostate cancer","volume":"19","author":"Hougen","year":"2023","journal-title":"J Clin Oncol Oncol Pract"},{"key":"2025090809173153300_djaf047-B4","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1158\/1055-9965.EPI-19-1344","article-title":"Racial\/Ethnic disparities in prostate cancer incidence, distant stage diagnosis, and mortality by U.S. Census Region and Age Group, 2012-2015","volume":"29","author":"Iyengar","year":"2020","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2025090809173153300_djaf047-B5","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1001\/jamaoncol.2022.5511","article-title":"Disparities in the inclusion of racial and ethnic minority groups and older adults in prostate cancer clinical trials: a meta-analysis","volume":"9","author":"Riaz","year":"2023","journal-title":"JAMA Oncol"},{"key":"2025090809173153300_djaf047-B6","doi-asserted-by":"publisher","first-page":"e2410162","DOI":"10.1001\/jamanetworkopen.2024.10162","article-title":"Social determinants of health and the availability of cancer clinical trials in the United States","volume":"7","author":"Sekar","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2025090809173153300_djaf047-B7","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1200\/OP.24.00206","article-title":"Association of community-level social vulnerability with clinical trial discussion and participation among cancer survivors","volume":"21","author":"Sekar","year":"2025","journal-title":"J Clin Oncol Oncol Pract"},{"key":"2025090809173153300_djaf047-B8","author":"Centers for Disease Control and Prevention\/Agency for Toxic Substances and Disease Registry\/Geospatial Research, Analysis, and Services Program"},{"key":"2025090809173153300_djaf047-B9","doi-asserted-by":"publisher","first-page":"pkab093","DOI":"10.1093\/jncics\/pkab093","article-title":"Racial disparities in access to prostate cancer clinical trials: a county-level analysis","volume":"6","author":"Wang","year":"2022","journal-title":"JNCI Cancer Spectr"},{"key":"2025090809173153300_djaf047-B10","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1001\/jamaoncol.2023.7314","article-title":"Analysis and optimization of equitable US cancer clinical trial center access by travel time","volume":"10","author":"Lee","year":"2024","journal-title":"JAMA Oncol"},{"key":"2025090809173153300_djaf047-B11","doi-asserted-by":"publisher","first-page":"106600","DOI":"10.1016\/j.cct.2021.106600","article-title":"Prostate cancer clinical trial completion: The role of geography","volume":"111","author":"Stensland","year":"2021","journal-title":"Contemp Clin Trials"}],"container-title":["JNCI: Journal of the National Cancer Institute"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jnci\/advance-article-pdf\/doi\/10.1093\/jnci\/djaf047\/62193744\/djaf047.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jnci\/article-pdf\/117\/9\/1934\/62193744\/djaf047.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jnci\/article-pdf\/117\/9\/1934\/62193744\/djaf047.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T13:17:41Z","timestamp":1757337461000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jnci\/article\/117\/9\/1934\/8044866"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,26]]},"references-count":11,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,2,26]]},"published-print":{"date-parts":[[2025,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jnci\/djaf047","relation":{},"ISSN":["0027-8874","1460-2105"],"issn-type":[{"value":"0027-8874","type":"print"},{"value":"1460-2105","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,9]]},"published":{"date-parts":[[2025,2,26]]}}}