Knowledge Attitude and Perception of Oncology Patients and Barriers to their Participation in Clinical Trials South West Nigeria

Abstract Background: Clinical trials are essential for advancing oncology treatments and improving patient outcomes. However, participation rates remain low, particularly in low- and middle-income countries like Nigeria. Objective: This study investigates the knowledge, attitudes, and perceptions of oncology patients toward clinical trials and identifies barriers to their participation in Lagos, Nigeria. Methods: A cross-sectional study was conducted at MEDSERVE-LUTH Cancer Centre (October 2024–April 2025) using structured questionnaires (N=330) and interviews. Data were analyzed using chi-square tests and inductive thematic analysis. Results: Only 23.9% were aware of clinical trials, with degree holders showing significantly higher awareness (31.0% vs ≤high school: 17.4%, p<.001). While 86.4% emphasized need for full risk/benefit disclosure, just 7.9% valued independent materials. Most (84.6%) believed trials benefit society, yet only 5.8% participated. Key barriers included unclear information (28.5%), personal constraints (20.9%), and cost concerns (17.3% overall; 23.8% among unemployed vs 6.5% employed, p<.001). Younger patients (<50 years) showed greater willingness to participate (69.1% vs ≥50 years: 57.5%, p=.02). Healthcare workers understood randomization better (43.8% vs 19.4%, p=.017). Motivators included access to best treatment (97.3%) and new therapies (67.6%). Notably, no participants reported feeling pressured. Conclusion: The low awareness and participation, coupled with demographic disparities in education, employment, and age, highlight the need for targeted interventions (e.g., financial support for unemployed patients, age-sensitive recruitment). Improving health literacy and physician engagement may enhance trial enrollment. Keywords: Clinical trials, oncology, patient perception, barriers, participation, Nigeria.