Methods
We retrospectively analyzed the SPIRS data from 1981 through 2020, looking at numbers of new diagnoses, care delivery sites and trial enrollment in cooperative group studies (CCG/POG/COG). There was no distinction between biologic and therapeutic studies in the SPIRS database. We examined the data in 5-year increments starting in 1981-1985 and ending in 2016-2020. Joinpoint regressions were used to estimate annual percentage changes (APCs) with the corresponding 95% confidence intervals in log-transformed percentages.