# A public map of trial deserts to steer where new sites open

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

## TL;DR

Combine registry cancer incidence by district with open trial site locations from ClinicalTrials.gov to map the regions where patients live more than an hour from any trial. Sponsors and funders would use it to decide where to open sites and justify site selection in diversity plans.

## Summary

An open, regularly updated geospatial dataset joins registry incidence (by county or district) with trial site locations and recruitment status from ClinicalTrials.gov and other registries, producing an index of trial access by disease, with travel-time isochrones and demographic overlays. Sponsors are asked to justify site selection against the map in diversity plans.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Regions identified as trial deserts and targeted for new sites will show increased enrolment of rural and minority patients within two years, and site-selection decisions of sponsors using the map will shift toward under-served regions.
- Rationale: Site selection is driven by past performance, not by where patients are, reinforcing concentration in the same academic centres. Maps changed resource allocation for pharmacies and emergency services.
- Proposed test: Publish the map for the US and one European country; compare geographic distribution of newly opened sites in the following two years with the prior two.
- Maturity: speculative
- Actor: data

## 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/)
- institutions: [International Agency for Research on Cancer (IARC / WHO)](https://onco.cc/institutions/iarc/)
- bottlenecks: [Data silos](https://onco.cc/bottlenecks/b-data-silos/), [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/)

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