Every person affected by cancer should have the opportunity to participate in research that reflects their needs, experiences, and communities. CCTG recognizes that systemic, historical, and ongoing barriers have contributed to inequities in cancer care and the underrepresentation of equity-deserving populations in clinical research. We are committed to embedding EDIIA across our clinical trials, research activities, and network. Through these efforts, CCTG is designing and conducting clinical trials that better reflect the diversity of people affected by cancer and advancing more equitable cancer care. This page highlights CCTG’s current EDIIA initiatives, including our efforts to advance reconciliation, improve access to clinical trials, and integrate EDIIA principles throughout our research and network. We will continue to update this page as we expand our efforts to make clinical trials more equitable, inclusive, and accessible for all. If you have any questions, comments, or feedback, please connect with the EDIIA Team at ediia@ctg.queensu.ca. Commitment to Reconciliation As a national cooperative group, CCTG recognizes the Indigenous lands both nationally and globally where our clinical trials and research activities occur. Our central office, located at the Operations and Statistics Centre at Queen’s University, is situated on traditional Anishinaabe and Haudenosaunee territory. We acknowledge and honour the Indigenous peoples who have been stewards of the lands and waters for centuries and who continue to call these lands home. We are grateful to live, work, and learn on these lands. To learn and reflect on the territories, treaties, and communities where you reside, visit Whose Land CCTG recognizes that First Nations, Inuit, and Métis peoples in Canada experience inequities in cancer outcomes, including cancer incidence, mortality, and access to cancer care. As part of our commitment to implementing the Truth and Reconciliation Commission of Canada's Calls to Action, we are working to address the harms of past research practices and build trust through meaningful relationships. Our efforts include strengthening reconciliation and decolonial education, fostering relationships with Indigenous partners, supporting culturally safe and co-designed research, and establishing guidelines for Indigenous clinical trial data governance. Improving Access and Representation in Clinical Trials EDIIA principles are core values of CCTG’s 2022—2027 Strategic Plan, which articulates a vision for a future where a cancer diagnosis is no longer a burden on Canadians, their families, and society, and where trial results identify cancer treatments that are effective, accessible, and affordable for all. CCTG recognizes that discriminatory practices, policies, and barriers within healthcare systems have contributed to the underrepresentation of equity-deserving populations in research and clinical trials. We are working to identify and address barriers to participation so that our trials are more equitable, inclusive, and accessible for all populations who may benefit from the results. Our health equity initiatives, informed by EDIIA principles focus on improving access to trials for populations that have been historically underrepresented in research, including: Indigenous peoples Racialized communities 2SLGBTQI+ communities Persons with disabilities Women Older adults and younger populations Newcomers to Canada Rural and remote communities Communities facing language barriers CCTG Study SC.32S, Feasibility, Acceptability and Representativeness: Collecting Sociodemographic Data in CCTG Trials, is collecting sociodemographic data from trial participants to better understand whether people participating in CCTG trials reflect the diversity of Canadians affected by cancer. These data will help identify barriers to participation and inform strategies to make CCTG trials more accessible. Learn more about SC.32S here. EDIIA Action Plan CCTG has taken a phased approach to embedding EDIIA across our organization, beginning with the development of an EDIIA Action Plan in 2021 to guide our commitment to EDIIA in our trials and network. The Action Plan focused on the following principles: EDIIA Strategy & Policy; Governance & Management; Operations and Statistics Centre Facility & Staff; Research Community & Network Users; and Research. All Action Plan activities across these five pillars were completed by early 2025, establishing a foundation for ongoing EDIIA integration across CCTG’s research activities and network operations. Workshops and Engagement Four equity-focused workshops have recently been held in conjunction with CCTG’s Annual Spring Meeting. Three workshops focused on two equity pilot trials (PR.25 (NCT06439225) and HN.13 (NCT06641791)) and brought together trial teams, CCTG leadership, cancer health equity experts, and patient partners to identify barriers and develop strategies to improve trial accessibility. Workshop recommendations have informed several initiatives, including: Protocol adaptions to improve trial accessibility EDIIA training in trial start-up webinars Trial Diversity Action Plans Translation of trial summaries into additional languages A reimbursement policy for trial-related expenses The fourth workshop focused on improving access to trials for older adults and was led by geriatric oncology experts and included patient partners and CCTG leadership. This workshop led to the creation of an Older Adults Working Group. EDIIA Working Groups In 2023, CCTG established three network-wide Working Groups focused on embedding EDIIA into trial design, methodology, data management, trial operations, and network activities. The Working Groups included over 50 network members and patient partners and met monthly over the course of a year to advance this work. Each Working Group developed a final report with recommendations that identified priority initiatives to advance EDIIA across CCTG’s trials, research activities, and network. Health Equity Committee In November 2024, CCTG Network Leadership endorsed the creation of a Health Equity Committee (HEC) following recommendations from the EDIIA Working Groups. The HEC provides guidance and support to integrate EDIIA priorities, objectives, and approaches across CCTG research, clinical trials, oversight processes, scientific committees, support committees, and network activities. The HEC brings together over 40 oncologists, clinical research personnel, health equity experts, and community advisors from across Canada. Through collaboration with patient partners, researchers, healthcare providers, Indigenous partners, and communities, the HEC works to identify and address barriers to clinical trial participation and advance more equitable, inclusive, and accessible research. Resources The resources below can assist with understanding the importance of health equity in cancer care and clinical trials and provide guidance on how to incorporate EDIIA into trial design and conduct. Health Equity in Cancer Care Canadian Cancer Society Report - Advancing Health Equity Through Cancer Information and Support Services Ensuring Equitable Access to Cancer Care for Black Patients Queering Cancer Equity in Clinical Research Multi-Regional Clinical Trials Centre of Brigham and Women’s Hospital Harvard - Diversity, Inclusion, and Equity in Clinical Research 3CTN Equity, Diversity, and Inclusion Toolkit Cultural Safety and Cultural Competency 3CTN Improving Trial Access for Indigenous Peoples N2 Cultural Competency Self-Assessment Checklist N2 Cultural Competency Skills in Clinical Research Online Course
