Individuals who identify as politically conservative were more likely to express skepticism about clinical trials than those with moderate or liberal ideologies, according to findings published in a research letter in JAMA Network Open.
Researchers found similar trends of political ideology influencing clinical trial skepticism when they looked only at cancer survivors.
“This pattern is consistent with broader polarization in trust toward scientific institutions and government health agencies, as well as variable participation in clinical trials,” the researchers wrote.
The cross-sectional study used data from the National Cancer Institute’s Health Information National Trends Survey 7 (HINTS 7), conducted in 2024, to examine the link between political ideology and clinical trial skepticism. The HINTS 7 survey asked individuals to respond on a 5-point Likert scale (strongly agree to strongly disagree) with the following statement: “People should be suspicious of clinical trials.” The primary exposure was political ideology: liberal, moderate, or conservative.
Researchers assessed associations between suspicion toward clinical trials and political ideology in the general US population and among cancer survivors.
A total of 6377 individuals responded to the trial skepticism question, including 1009 cancer survivors. Just over half of respondents were women, and 60% were non-Hispanic White.
In the overall sample, 27.2% agreed that people should be suspicious of clinical trials. Cancer survivors were not significantly more likely to express suspicion toward trials compared with nonsurvivors (P =.13).
Compared with respondents who neither agreed nor disagreed, conservatives were more likely than liberals to agree with the statement “People should be suspicious of clinical trials” (adjusted odds ratio [aOR], 1.30; 95% CI, 1.10-1.54). Conservatives were also more likely to agree than moderates (aOR, 1.43; 95% CI, 1.22-1.67).
In contrast, individuals who identified as politically liberal were more likely than moderates to disagree that people should be suspicious of clinical trials (aOR, 1.98; 95% CI, 1.70-2.31), compared with a reference group of respondents who neither agreed nor disagreed.
Among cancer survivors, the same trends emerged, with conservative cancer survivors expressing greater distrust of clinical trials, but subgroup estimates were “less precise,” the researchers wrote.
The researchers noted that the study is limited by the single-item measure of clinical trial suspicion and by the small response rate (27.3%) to the HINTS 7 survey.
However, the study findings suggest the need for “urgent” action, the researchers wrote. “If political ideology influences receptivity to clinical trials, recruitment strategies that overlook ideological diversity risk biased enrollment and underrepresentation,” they wrote.
By recognizing political ideology as one factor in medical mistrust, researchers could potentially reduce barriers to trial enrollment, they suggested.
“Interventions could include ideologically congruent messaging, clinician-mediated invitations emphasizing local oversight and patient confidentiality, efforts to diversify clinical trialists, and community partnerships that build credibility across political groups,” the researchers wrote.
Disclosures: This research was supported by the Robert Wood Johnson Foundation Harold Amos Medical Faculty Award. The study authors reported having no conflicts of interest. Please see the original reference for complete disclosures.