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Cancer trial accrual is a national priority, yet up to 20% of trials fail to accrue. Trial eligibility criteria growth may be associated with accrual failure. We sought to quantify eligibility criteria growth within National Cancer Institute (NCI)‐affiliated trials and determine impact on accrual.

Utilizing the Aggregated Analysis of ClinicalTrials.gov, we analyzed phase II/III interventional NCI‐affiliated trials initiated between 2008 and 2018. Eligibility criteria growth was assessed via number of unique content words within combined inclusion and exclusion criteria. Association between unique word count and accrual failure was evaluated with multivariable logistic regression, adjusting for known predictors of failure. Medical terms associated with accrual failure were identified via natural language processing and categorized.

Of 1197 trials, 231 (19.3%) failed due to low accrual. Accrual failure rate …