# Fund investigators from under-represented communities and community sites to lead trials

Source: https://onco.cc/ideas/idea-tr1-diverse-investigator-pipeline/  
OnCo record `idea-tr1-diverse-investigator-pipeline` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Patients are more likely to join a trial when the doctor offering it looks like them or works in their community. Funding more such doctors to become trial leaders would change who is enrolled.

## Summary

Career development awards, protected time and mentorship for oncologists from under-represented groups and those practising in community, rural and safety-net settings, tied to becoming principal investigators. Cooperative groups set targets for the share of PIs from these backgrounds. Evidence that racial concordance and community-based investigators raise minority enrolment is observational but consistent.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Sites led by investigators from under-represented groups or based in community settings will enrol a higher share of minority and low-income participants, and increasing their number will shift network-level representativeness.
- Rationale: Investigator distribution mirrors academic centre demographics; recruitment relationships run through clinicians. Workforce interventions have long lags but compound.
- Proposed test: Fund 50 awards over five years and compare enrolment demographics at awardees' sites with matched non-awardee sites.
- Maturity: early-clinical
- Actor: philanthropy

## Sources

- Bottleneck evidence (Trials do not represent the people who get cancer): Loree et al., Disparity of race reporting and representation in trials leading to cancer drug approvals (JAMA Oncology 2019): https://doi.org/10.1001/jamaoncol.2019.1870

## Connected records

- institutions: [American Association for Cancer Research (AACR)](https://onco.cc/institutions/aacr/), [American Society of Clinical Oncology (ASCO)](https://onco.cc/institutions/asco/), [National Cancer Institute (NIH)](https://onco.cc/institutions/nci/)
- bottlenecks: [Not enough oncologists, nurses, pathologists, physicists](https://onco.cc/bottlenecks/b-workforce/), [Trials do not represent the people who get cancer](https://onco.cc/bottlenecks/b-trial-diversity/)
- key papers: [Disparity of Race Reporting and Representation in Clinical Trials Leading to Cancer Drug Approvals From 2008 to 2018](https://onco.cc/key-papers/paper-loree-jama-oncol/)

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