Diné College undergraduates Harrison Cayatineto, Gilberta Yazzie, and Chantanielle S. Clyde have been working on healthcare disparities in the college’s pharmacogenetics laboratory. Now, they have published three papers in clinical cancer research. These studies are retrospective analyses of cancer clinical trials in the United States.

The first paper, by lead author Harrison Cayatineto, is entitled “The Systemic Exclusion of Native Americans from Cancer Clinical Trials” and was published in the Journal of Medical Research and Health Science. The second paper, by Gilberta Yazzie, is entitled “Colon Cancer: The Exclusion of Native Americans and Hispanics from Clinical Trials in the United States” and was published in the Acta Journal of Medical Science. And the third paper, by Chantanielle S. Clyde, entitled “The Underrepresentation of Minorities and Non-Generalizability of Breast Cancer Clinical Trials?” was published in the Innovative Journal of Medical and Health Science.

All of the papers investigate how therapeutic interventions to treat cancer are determined by the outcome of clinical trials that seek a high efficacy and low toxicity for a particular cancer treatment. The efficacy and toxicity are determined by the interplay of the medication with an individual’s biology, which differs even within a particular ethnic group. These differences are magnified between ethnic groups; hence, clinical trials that only include one ethnic group may not be generalizable. This means the treatment may not work as well in various ethnic groups and may even be toxic or deadly.

In the paper by Yazzie et al., only two Native Americans could be identified out of half a million clinical trial participants for colon cancer. These papers provide evidence for the higher death rates from cancer for Native Americans—even though they are less likely to get cancer— in part due to the non-generalizability of cancer clinical trials, which in turn is due to the exclusion of Native Americans and other ethnic minorities from clinical trials.