Barriers to Clinical Trial Enrollment: KCSG Survey-Based Perspectives of Medical Oncologists, Patients, and Their Caregivers

Abstract

Purpose: Despite the critical role of clinical trials in advancing cancer treatment, patient enrollment remains challenging in South Korea. We aimed to identify key barriers to clinical trial participation from the perspectives of medical oncologists, patients, and caregivers.

Materials and methods: Two web-based surveys were conducted in August 2022: one involving 100 KCSG-affiliated medical oncologists, and another involving 100 cancer patients and 100 caregivers. Structured questionnaires were used to assess experiences, perceived barriers, and access to trial-related information. Focus group interviews (FGIs) were conducted with six patients and caregivers to explore qualitative insights in greater depth.

Results: Among oncologists, 98% had prior experience with clinical trials; the same proportion expressed willingness to refer patients to other institutions. However, 76% reported failed or abandoned referral attempts, primarily due to insufficient information on trial eligibility and enrollment status. Although 86% of patients and caregivers were aware of the clinical trial, only 23% had actual participation experience. Physician recommendations emerged as the most influential factor driving participation. Nonetheless, most reported difficulties in accessing reliable trial information, citing unfamiliarity with search tools, complex content, and absence of centralized platforms. The FGI findings supported these results, highlighting the importance of physician guidance and identifying limited access to information as major barriers to enrollment.

Conclusion: Despite positive attitudes, clinical trial participation remains constrained by fragmented referral systems and inaccessible information. Establishing a coordinated, interinstitutional referral platform and improving user-friendly information delivery may enhance enrollment and promote equitable access to cancer clinical trials in South Korea.