Introduction
Social determinants of health (SDoH) are associated with stark disparities in adult and pediatric cancer outcomes.1-3Adverse SDoH—including poverty, unmet material needs, and unsafe environmental conditions—drive higher cancer incidence, limited clinical trial access, and lower overall survival for individuals from low socioeconomic status or historically marginalized backgrounds.3-8 Despite robust evidence that SDoH are independent risk factors for cancer outcomes9, US cancer trials have historically failed to collect these data. Only 63% of US oncology drug trials in the last decade even reported race, a proxy for SDoH exposure due to longstanding structural racism.10
The majority of pediatric oncology care nationwide is delivered via multi-institutional clinical trials—thus, trial-integrated SDoH data collection is critical to assess equitable access to cutting-edge therapeutic options, evaluate generalizability of trial findings to a real-world context, and identify opportunities for health-equity interventions in the trial setting.11 We have previously demonstrated the feasibility of systematic, parent-reported SDoH evaluation in a clinical context in a single center.12 However, there are no existing data on the feasibility of this approach as a standardized component of a first-line therapeutic clinical trial, and SDoH data collection is not routinely conducted as a part of cooperative group trials. We report here the feasibility of the first pediatric oncology multicenter trial-embedded SDoH investigation.