# Lay trial navigators funded per centre, evaluated in a randomised trial

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

## TL;DR

A trained non-clinical guide who explains trials, arranges logistics and keeps in touch could make the difference between a patient hearing about a trial and actually joining one.

## Summary

Fund one lay navigator per 300 new cancer patients at community and safety-net hospitals, with a defined role: identify potentially eligible patients from matching tools, explain trials in plain language, coordinate screening logistics and follow up. Patient navigation improves timeliness of cancer care; the specific effect on trial enrolment has small positive studies and deserves a definitive randomised test.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Patients randomised to a navigator will have at least a 50 percent higher trial enrolment rate than usual care, with the largest effect in minority and low-income patients.
- Rationale: Enrolment fails on logistics and trust more than on eligibility. Navigators address both and are far cheaper than clinical staff.
- Proposed test: Individually randomised trial at six hospitals, 3,000 newly diagnosed patients, primary outcome enrolment in any interventional trial within 12 months.
- Maturity: early-clinical
- Actor: philanthropy

## Sources

- Bottleneck evidence (Trials enrol too few, too slowly): Unger et al., Systematic review of barriers to cancer trial participation (JNCI 2019): https://doi.org/10.1093/jnci/djy221

## Connected records

- institutions: [American Society of Clinical Oncology (ASCO)](https://onco.cc/institutions/asco/), [National Cancer Institute (NIH)](https://onco.cc/institutions/nci/)
- 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/)

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