Racial representation in clinical research supporting NCCN small cell lung cancer practice guidelines.

239 Background: Racial and ethnic disparities in cancer care persist, with Black individuals facing higher lung cancer incidence (15%) and mortality rates (18%) compared to Whites, alongside lower likelihood of early detection (16% vs. 20%) and access to curative therapies [CA Cancer J Clin 2019;69:211]. NCCN guidelines are critical for SCLC diagnosis and treatment, prompting examination of racial demographic reporting in cited studies. Methods: We conducted a systematic retrospective review of 311 references in NCCN SCLC Guidelines Version 3 to assess racial demographic reporting in clinical studies. Primary endpoint was proportion of studies reporting racial demographics. Clinical studies were included; reviews and non-clinical research were excluded. We analyzed racial representation trends (1980–2024) using Fisher's exact test and Mann-Kendall analysis. Studies without racial data were classified as non-reporting. Results: 311 references were reviewed, and 208 were excluded based on predetermined criteria. Of the remaining 103 references, 31 (30.1%) clinical studies reported racial data. While the proportion of studies reporting race increased numerically from 15.2% (5/33) in 1980–1999 to 60.0% (9/15) in 2020–2024, Fisher’s exact test (p = 0.07) indicated that this rise was not statistically significant, suggesting no clear increasing trend in race reporting over decades. U.S. studies reported race more frequently (20/34, 58.8%) than international studies (11/69, 15.9%). Many studies aggregating minorities into “non-White” categories did not provide distinct counts for Black or other underrepresented groups. The Mann-Kendall trend analysis showed no significant decrease in the proportion of Whites over time (t-test score = -0.6; p > 0.05). Conclusions: Less than one-third of clinical studies in the NCCN SCLC guidelines report racial demographics. Although there was a numerical increase in reporting across the decades, this did not reach statistical significance, and there was also no significant decrease in the proportion of Whites reported. Reporting was more common in U.S. studies, but many still lack transparency regarding specific minority representation. These findings highlight the need for standardized race and ethnicity reporting in SCLC trials to ensure guidelines apply to all patients. SCLC clinical studies reporting race over time. Time Block White (%) Non-White (%) Black (%) Asian (%) AI/AN (%) NH/PI (%) Hispanic (%) ≥2 Races (%) 1980–1999 89.4 9.7 0.9 0.0 0.0 0.0 0.0 0.0 2000–2004 97.0 2.2 0.6 0.0 0.0 0.0 0.2 0.0 2005–2009 91.9 0.1 5.3 0.4 0.1 0.0 2.2 0.0 2010–2014 91.4 0.0 4.5 2.1 0.4 0.4 0.0 1.3 2015–2019 85.7 0.0 0.8 13.5 0.0 0.0 0.0 0.0 2020–2024 72.7 7.9 3.7 15.0 0.2 0.0 0.5 0.0 Total 90.1 0.8 4.3 3.1 0.3 0.3 0.1 1.1 AI/AN = American Indian/Alaska Native; NH/PI = Native Hawaiian/Pacific Islander.