Reporting of Racial and Ethnic Diversity in Dermatology Clinical Trials Involving Canada, 2020 to 2025: A Systematic Review
In brief
Indigenous participants account for only 0.2% of enrollments in Canadian dermatology trials
In a review of 99 dermatology randomized trials (36,178 participants) published 2020-2025, race was listed in 93% of studies but ethnicity in just 39% and skin type in 10%; detailed categories matched census definitions in only 1% of trials. Visible minorities were proportionally represented, yet Indigenous people were vastly under-enrolled and demographic data were rarely used in analyses, highlighting a gap in equitable trial design.
- Journal
- Journal of cutaneous medicine and surgery (Q1)
- Published
- 27 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Hiba Elhaj, Amina Moustaqim-Barrette, Sarah Aly, Marissa Joseph, Elena Netchiporouk, Reetesh Bose
- PMID
- 42504406
- DOI
- 10.1177/12034754261467036
Why clinicians should know about it
- Picked for Dermatology (top studies of the week, 2 August 2026): Reporting of racial/ethnic diversity in Canadian dermatology RCTs
Abstract
Randomized clinical trials (RCTs) guide dermatologic care, yet reporting of participant race, ethnicity, and skin type is inconsistent. Post-2020 initiatives aimed to improve equity, but contemporary Canadian dermatology trials have not been systematically evaluated. This review assessed the frequency, quality, and consistency of race, ethnicity, and Fitzpatrick skin-type reporting in dermatology RCTs involving Canadian participants and compared representation with Canadian population demographics. Phase 2 to 4 dermatology RCTs including Canadian participants published between January 2020 and July 2025 were identified via PubMed and ClinicalTrials.gov using disease-specific terms. Trial characteristics, demographic reporting, and analytic use of race, ethnicity, and skin type were extracted. Demographics were standardized to 2021 Canadian Census categories. Analyses were performed at the trial level due to limited site-specific enrollment data. Ninety-nine RCTs (36 178 participants) were included; most studied psoriasis (44%) or eczema (41%) and were industry-funded (98%). Race was reported in 93% of trials, ethnicity in 39%, and Fitzpatrick skin type in 10%. Detailed racial or ethnic categories appeared in 37% of trials, and only 1% aligned with Census categories. Seven percent used demographic data in analyses. Across aggregate multinational enrollment, visible minority representation approximated national benchmarks (23% vs 26.5%), while Indigenous participants were markedly underrepresented (0.2%). Multinational designs and limitations in site-level reporting restrict precise assessment of Canadian enrollment. Race reporting in Canadian dermatology RCTs is now routine, but diverse enrollment and analytic use of demographic data remain limited. Standardized reporting, site-level enrollment data, and culturally appropriate recruitment are needed to improve representation and ensure findings reflect Canada's diverse population.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.