Adolescents and young adults (AYAs) are underrepresented in cancer clinical trials (CCTs). Limited trial enrollment slows progress in improving survival rates and prevents the collection of valuable biospecimens. A systematic literature review was conducted to assess barriers and facilitators to AYA enrollment in CCTs and to identify opportunities to improve enrollment. The PubMed MEDLINE, Web of Science, Scopus, and PsycINFO databases were searched to identify studies relevant to AYA CCT enrollment. Eligibility criteria included the qualitative and/or quantitative evaluation of barriers and facilitators to AYA enrollment. One hundred fifty-five unique publications were identified; 13 were included in the final analysis. Barriers to AYA enrollment in CCTs included a lack of existing trials applicable to the patient population, limited access to available CCTs, and a lack of physician awareness of relevant trials. Facilitators of enrollment included optimizing the research infrastructure, improving the awareness of available CCTs among providers, and enhancing communication about CCTs between providers and patients. In conclusion, the limited available research reports institution- and patient-level barriers and facilitators to AYA CCT enrollment. Because of persistent disparities in AYA enrollment, there is an urgent need to further identify the barriers and facilitators to AYA CCT enrollment to determine actionable areas for intervention.

中文翻译：

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对患有癌症的青少年和年轻人进行临床试验招募的障碍和促进因素进行系统审查：确定干预机会。

青少年和年轻人 (AYA) 在癌症临床试验 (CCT) 中的代表性不足。有限的试验招募减缓了提高生存率的进展，并阻碍了有价值的生物样本的收集。我们进行了系统的文献综述，以评估 CCT 中 AYA 入学的障碍和促进因素，并确定提高入学率的机会。检索了 PubMed MEDLINE、Web of Science、Scopus 和 PsycINFO 数据库，以确定与 AYA CCT 注册相关的研究。资格标准包括对 AYA 入学障碍和促进因素的定性和/或定量评估。确定了一百五十五种独特的出版物；13人纳入最终分析。AYA 纳入 CCT 的障碍包括缺乏适用于患者群体的现有试验、获得可用 CCT 的机会有限以及医生缺乏对相关试验的认识。入组的促进因素包括优化研究基础设施、提高提供者对可用 CCT 的认识，以及加强提供者和患者之间有关 CCT 的沟通。总之，有限的可用研究报告了 AYA CCT 注册的机构和患者层面的障碍和促进因素。由于 AYA 入学率持续存在差异，迫切需要进一步确定 AYA CCT 入学率的障碍和促进因素，以确定可采取行动的干预领域。