Is Racial and Ethnic Representation in Oncology Clinical Trials Improving?
Expert Perspectives · Keira Smith · 2026-06-24
The lack of diversity in medical research has long been a critical blind spot in oncology, raising concerns that life-saving treatments may not be equally effective or safe across different genetic backgrounds. To address this gap, Dr. Jiasheng Wang and his team conducted a study, presented at the American Society of Clinical Oncology (ASCO) Annual Meeting, that used artificial intelligence (AI) to evaluate whether 30 years of research have actually moved the needle on patient representation. Afterwards, he sat down with Dr. Waqas Haque to explore whether racial and ethnic representation in oncology clinical trials has really changed or if the benefits of innovation are still failing to reach the most underserved communities.
AI Meets Trial Data
Dr. Wang described the study’s technical approach: PDFs were converted to images and processed by multimodal large language models (LLMs) to pull tables and figures. The automation was striking: "We have all the data obtained in that short period of time." He added that models were able to extract demographic entries reliably—"the model is powerful enough to perform accurate extraction from the data in these papers." Manual checks were applied to validate a portion of the results.
Key Findings
Reporting of representation in clinical trials increased markedly over 30 years, from roughly 16% of publications in 1995-2005 to 47% in 2016-2025. As Dr. Wang put it, "the reporting of the racial and ethnic components of clinical trials has increased dramatically, having tripled over the 30-year period of time." Yet this improved reporting masks an important nuance: much of the non‑White enrollment growth was driven by trials in Asia. Meanwhile, several US minority groups saw little or negative change: "these patients still haven’t seen an increased trend over the years."
Barriers to Equitable Enrollment
The study highlights structural obstacles. Dr. Wang noted the practical burdens that trials impose: "Being in a clinical trial is pretty complex. They require a lot of follow-ups." Economic constraints, travel distance, complex consent forms, and language barriers remain powerful deterrents to participation—especially for Black and Hispanic communities, where median representation remained low or declined.
How AI Can Help
While trial design and site selection remain research- and policy-driven, Dr. Wang emphasized pragmatic AI applications to reduce enrollment barriers. For example, "We can use AI to simplify the consent language so that patients with different levels of education can better understand the terms." Translation, patient-facing Q&A tools, and streamlined digital follow-up could make trials more accessible and reduce attrition that disproportionately affects disadvantaged groups.
Conclusion
The analysis demonstrates how AI can scale retrospective evaluation of representation across thousands of trials and reveal nuanced trends: better reporting but uneven inclusion. Global expansion of trials has increased non‑White participation overall, yet the communities most in need of representation in the US remain underrepresented. The implementation of AI-driven tools could help to remove barriers and improve equitable access to trials going forward.
Key Takeaways
Reporting of race and ethnicity in oncology trials has increased substantially over 30 years, but reporting does not mean equitable inclusion.
Growth in non‑White enrollment has been driven largely by Asia rather than improved inclusion of US minority groups.
Black and Hispanic participation remains low; some groups saw declining median enrollment.
Structural barriers—logistics, complex consent, language—continue to limit diverse enrollment.
Practical AI solutions, such as simplified consent, translations, and patient Q&As, could lower barriers and improve equitable access to trials.
About the Speakers
Waqas Haque, MD, MPH, is a second-year Hematology/Oncology Fellow at the University of Chicago. He recently completed his Internal Medicine Residency at New York University (NYU) in a Clinical Investigator Track. Dr. Haque has balanced his patient care work with a variety of research projects. During his fellowship training at the University of Chicago, he plans to further his work in innovative clinical trial design, value-based care delivery to cancer patients, and clinical investigation.
Jiasheng Wang, MD, is an Assistant Professor of Hematology at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. He specializes in the treatment of blood cancers and has expertise in bone marrow transplantation, immunotherapy, and graft-versus-host disease. Dr. Wang is passionate about treatment blood cancers with a holistic approach that considers each patient’s physical, mental, and social well-being.