# Set trial enrolment targets from who actually gets the disease, and publish progress live

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

## TL;DR

Each trial would set its target mix of patients from cancer registry data on who gets that cancer, by age, sex and ethnicity, and show a public running tally so gaps are visible while there is still time to fix them.

## Summary

Sponsors derive enrolment targets per stratum from incidence data (SEER, GLOBOCAN, national registries) for the indication and the countries where the trial runs, publish the targets in the registry record, and update enrolled counts quarterly. Recruitment resources are reallocated during the trial toward under-enrolled strata (site additions, navigators, translated materials).

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Trials with live public stratum tallies will finish closer to incidence-weighted targets than trials with static goals, because course correction happens during accrual rather than being noted at the end.
- Rationale: Enrolment gaps are usually discovered at analysis, too late to correct. Live dashboards changed vaccination and screening coverage by making gaps actionable.
- Proposed test: Randomise a sponsor's new trials to live public tallies or internal-only tracking and compare final representativeness.
- Maturity: early-clinical
- Actor: industry

## 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

- collections: [ClinicalTrials.gov](https://onco.cc/collections/clinicaltrials-gov/), [GLOBOCAN / Global Cancer Observatory](https://onco.cc/collections/globocan/), [SEER (Surveillance, Epidemiology, and End Results)](https://onco.cc/collections/seer/)
- bottlenecks: [Trials do not represent the people who get cancer](https://onco.cc/bottlenecks/b-trial-diversity/), [Trials enrol too few, too slowly](https://onco.cc/bottlenecks/b-trial-enrolment/)
- 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/), [Unger: most patients never get the chance to join a cancer trial, and when offered, half say yes](https://onco.cc/key-papers/paper-unger-trial-participation-barriers-jnci-2019/)

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