Despite three decades of federal legislation aimed at improving minority participation in medical research, Black and Hispanic men remain severely underrepresented in advanced prostate cancer clinical trials. A troubling new analysis reveals that progress has not just stalled—it has reversed.
Researchers examined 33 major prostate cancer trials conducted between 2005 and 2021, involving nearly 7,000 men. They found that almost 40 percent of trials failed to report race data at all, while 67 percent omitted ethnicity information entirely. More alarming, Black participation plummeted from 13.7 percent in early trials to just 3 percent by 2020-2021, even as national awareness of health disparities intensified.
This declining representation occurs against a backdrop of stark mortality differences. Black men experience excessive death rates from prostate cancer compared to White men, making their exclusion from potentially life-saving treatment research particularly consequential.
The 1993 NIH Revitalization Act specifically mandated inclusion of minorities in federally funded trials, explicitly stating that cost could not justify their exclusion. Yet the analysis found that 94 percent of trials were industry-funded, potentially circumventing these requirements.
Standard trial eligibility criteria may disproportionately exclude Black men, while lack of community trust, poverty, and limited access to quality care create additional barriers. The author notes that NCI-designated cancer centers, which serve catchment areas covering over 230 million Americans, must intensify efforts to address these persistent disparities.
Without transformative change, minority communities will continue missing opportunities to benefit from therapeutic advances.
See: “Challenge of Underrepresentation of Black and Hispanic Men in Advanced Prostate Cancer Trials—Progress?” (January 7, 2026)
