Improving clinical trial enrollment in minority racial and ethnic patients with gynecologic malignancy

•Low minority enrollment into clinical trials remains a critical issue in the setting of rising incidence and mortality rates among minority patients with gynecologic malignancies.•Pre-screening and fast-track referral implementation strategies in a large urban academic hospital increased minority screening 5-fold and enrollment 3.5-fold.•Screening and enrollment most robustly increased among uterine cancer patients. Racial and ethnic minorities remain underrepresented in clinical trials . Underrepresentation of racial groups leads to the selection of therapeutic interventions that may not be representative of the population expected to use the medicine. This study evaluates the effectiveness of a set of implementation strategies to increase underrepresented patients in gynecologic cancer clinical trials. An interrupted time series analysis evaluating implementation strategies (pre-screening and fast-track referral) was conducted from January 2021 to May 2022. Descriptive analysis of gynecologic oncology patient screening and accrual was compared before and after intervention implementation. During the study period (pre- and post-intervention), 26 patients were screened, and 9 patients enrolled in therapeutic gynecologic cancer clinical trials. Prior to the intervention, 7 patients were screened and 2 patients enrolled onto a clinical trial. Following the intervention, 19 patients were screened and 7 patients enrolled in a cancer clinical trial. Black patients comprised 13 of 19 (68.4%) of patients post-intervention compared to 1 of 7 (14.3 %) of patients screened pre-intervention (p