Comparing concordance of prostate cancer clinical trials and disease incidence in the United States in 2021 and 2022.

335 Background: Prostate cancer is the second-leading cause of cancer-related death in men in the United States. However, only about 5% of cancer patients in the United States are enrolled in a clinical trial. As of January 2022, clinical trial costs were mandated to be covered by Medicaid. We investigated whether or not this change in policy might have improved access to care by comparing the clinical trial and prostate cancer incidence from 2021 and 2022. Methods: Incidence data was obtained from the 2021-2022 Center for Disease Control U.S. Cancer Statistics database. Clinical trial enrolment was obtained from ClinicalTrials.gov, accounting for recruited persons from January 1 to December 31 of each year. Trial availability rates were normalized to per 100,000 persons per state. The incidence of prostate cancer and number of clinical trials per state were correlated with linear regression. Results: The average age-adjusted incidence per 100,000 for the nation in 2021 was 115.176 (±15.668), which increased to 120.616 (±16.992) in 2022. The states with the highest incidence being New Jersey (147.4) in 2021 and Maine (157.0) in 2022. Arizona stayed the state with the lowest incidence with 80 in 2021 and 81.5 in 2022. The average unique prostate cancer clinical trials per state per 100,000 was .808 (±1.379) in 2021 and .321 (±.2085). In 2021, we found that there was no significant correlation (coefficient of 0.0435, r2=.00001) between the incidence of disease and clinical trial access when normalized to the population. However, in 2022, we found that there was a significant correlation (coefficient of 3.316 r2 =0.0017) between disease incidence and clinical trials. We found that New Jersey and Maine which had the highest incidence each year, were ranked 39th (.109 trials) and 37th ( .1337 trials) out of the 50 states. As of January 2022, costs of clinical trials are mandated to be covered by Medicaid, which may affect both trial enrollment and medical center participation, shifting the research landscape towards greater inclusivity for all patients. Further directions would include comparing this data to more recent data as it becomes available each year, as well as comparing Medicaid enrollment data for the same time frame. Conclusions: We hope to elucidate how this policy change provides access and can lead to new clinical trials, especially in states with large increases in incidence, such as New Mexico and Maine.