To the Editor In their Research Letter published in JAMA Oncology, Fleury et al¹ suggest that patients with cancer will be less likely to consider trial participation even when sites return to prepandemic status. Nevertheless, we would like to point out that this conclusion should be interpreted cautiously because this study has several limitations, and mechanistic factors to support these findings are missing.

In the first place, this study¹ was conducted in a US cancer survivor population with only 30% of responses and without specifying whether the patients were in remission or not. However, a patient’s decision is based on a benefit–risk ratio in which the more benefit they expect, the more risk (even due to COVID-19) they are willing to take. Moreover, it is important to emphasize that among 907 respondents, the majority of patients (743 [81.9%]) indicated no difference in their willingness (or were even more likely for 22 of them) to participate in a clinical trial.