Reach

Canada’s clinical trial access gap, measured

Clinical trials in Canada are concentrated in a handful of cities. This page measures that concentration directly from the trial registry — every figure computed when you loaded the page, with its method shown. Nothing here is an estimate.

Computed September 10, 2026 from 8,966 Canadian trial site records (8,877 with coordinates) across 2,859 trials.

Headline statistics

57.6%

of Canadian trials are available only in eight cities

1,648 of 2,859 trials

184

Canadian cities have any trial site at all

157 of them have coordinates and appear on the map below

9

of Canada’s 129 largest centres are over 100 km from a recruiting trial

6 are over 250 km

How this is calculated

Every Canadian trial site in the corpus is matched to its city. A trial counts as "only in these eight cities" when every one of its Canadian sites is in Toronto, Montreal, Vancouver, Ottawa, Calgary, Edmonton, Québec, London. Computed across 2,859 trials with at least one Canadian site.

Where the trials are

All sitesRecruiting only
45°N50°N55°N60°N65°N70°N130°W110°W90°W70°WOnt.Que.B.C.Alta.N.S.Man.Sask.N.B.Toronto, ON — 1,294 trials, 1,659 sitesMontreal, QC — 921 trials, 1,300 sitesVancouver, BC — 486 trials, 531 sitesEdmonton, AB — 457 trials, 505 sitesCalgary, AB — 428 trials, 471 sitesOttawa, ON — 404 trials, 434 sitesHamilton, ON — 376 trials, 426 sitesLondon, ON — 374 trials, 402 sitesQuébec — 359 trials, 416 sitesHalifax, NS — 232 trials, 238 sitesWinnipeg, MB — 191 trials, 215 sitesSherbrooke, QC — 181 trials, 189 sitesSaskatoon, SK — 112 trials, 117 sitesKingston, ON — 111 trials, 119 sitesBrampton, ON — 72 trials, 76 sitesTrois-Rivières, QC — 70 trials, 73 sitesKelowna, BC — 67 trials, 71 sitesSurrey, BC — 60 trials, 63 sitesRegina, SK — 60 trials, 63 sitesSt. John's, NL — 56 trials, 58 sitesBarrie, ON — 54 trials, 55 sitesChicoutimi, QC — 53 trials, 53 sitesVictoria, BC — 52 trials, 58 sitesMississauga, ON — 50 trials, 50 sitesNewmarket — 45 trials, 47 sitesOshawa, ON — 43 trials, 43 sitesMoncton, NB — 39 trials, 41 sitesGreater Sudbury, ON — 38 trials, 40 sitesGreenfield Park, QC — 37 trials, 37 sitesWindsor, ON — 33 trials, 33 sitesLévis, QC — 33 trials, 33 sitesMarkham, ON — 32 trials, 33 sitesKitchener, ON — 32 trials, 33 sitesScarborough Village, ON — 30 trials, 32 sitesSaint John, NB — 30 trials, 31 sitesSarnia, ON — 30 trials, 30 sitesWaterloo, ON — 29 trials, 30 sitesOakville, ON — 29 trials, 29 sitesLaval, QC — 27 trials, 28 sitesNew Westminster, BC — 27 trials, 27 sitesGuelph, ON — 25 trials, 25 sitesThunder Bay, ON — 24 trials, 26 sitesAjax, ON — 24 trials, 24 sitesFredericton, NB — 22 trials, 24 sitesCambridge, ON — 21 trials, 23 sitesPeterborough, ON — 21 trials, 21 sitesRimouski, QC — 19 trials, 19 sitesSaint-Charles-Borromée, QC — 18 trials, 19 sitesVaughan, ON — 18 trials, 18 sitesBurlington, ON — 18 trials, 18 sitesSt. Catharines, ON — 17 trials, 18 sitesRed Deer, AB — 17 trials, 17 sitesVerdun — 16 trials, 16 sitesTerrebonne, QC — 16 trials, 16 sitesStoney Creek, ON — 16 trials, 16 sitesSaint-Jérôme, QC — 15 trials, 17 sitesWhitby, ON — 14 trials, 14 sitesRichmond Hill, ON — 14 trials, 14 sitesAbbotsford British Columbia, BC — 14 trials, 14 sitesRichmond, BC — 13 trials, 13 sitesEtobicoke, ON — 12 trials, 13 sitesStouffville, ON — 12 trials, 12 sitesSault Ste. Marie, ON — 12 trials, 12 sitesSydney, NS — 10 trials, 10 sitesNorth Vancouver, BC — 10 trials, 10 sitesWinchester, ON — 9 trials, 12 sitesVictoriaville — 9 trials, 9 sitesPrince George, BC — 9 trials, 9 sitesLethbridge, AB — 9 trials, 9 sitesSherwood Park — 8 trials, 8 sitesNiagara Falls — 8 trials, 8 sitesLongueuil, QC — 8 trials, 8 sitesKentville, NS — 8 trials, 8 sitesBurnaby, BC — 8 trials, 8 sitesNorth Bay, ON — 7 trials, 7 sitesJoliette, QC — 7 trials, 7 sitesScarborough — 6 trials, 9 sitesGatineau, QC — 6 trials, 6 sitesTruro, NS — 5 trials, 5 sitesSaguenay, QC — 5 trials, 5 sitesKamloops — 5 trials, 5 sitesCourtice — 5 trials, 5 sitesConcord, ON — 5 trials, 5 sitesBridgewater, NS — 5 trials, 5 sitesBrantford, ON — 5 trials, 5 sitesSt. Albert, AB — 4 trials, 4 sitesNanaimo, BC — 4 trials, 4 sitesMount Royal, QC — 4 trials, 4 sitesMirabel, QC — 4 trials, 4 sitesEast York, ON — 3 trials, 4 sitesThornhill, ON — 3 trials, 3 sitesSaint-Laurent, QC — 3 trials, 3 sitesSaint-Jean-sur-Richelieu, QC — 3 trials, 3 sitesPenticton, BC — 3 trials, 3 sitesOrillia, ON — 3 trials, 3 sitesMedicine Hat, AB — 3 trials, 3 sitesDieppe, NB — 3 trials, 3 sitesCharlottetown, PE — 3 trials, 3 sitesChilliwack, BC — 2 trials, 3 sitesWestmount, QC — 2 trials, 2 sitesSainte-Marie, QC — 2 trials, 2 sitesSaint-Lambert, QC — 2 trials, 2 sitesPointe-Claire, QC — 2 trials, 2 sitesNepean, ON — 2 trials, 2 sitesLangley, BC — 2 trials, 2 sitesGrande Prairie, AB — 2 trials, 2 sitesCobourg, ON — 2 trials, 2 sitesCanmore, AB — 2 trials, 2 sitesBoisbriand, QC — 2 trials, 2 sitesArviat, NU — 1 trial, 2 sitesWoodstock, ON — 1 trial, 1 siteWhistler, BC — 1 trial, 1 siteWest Vancouver, BC — 1 trial, 1 siteWelland, ON — 1 trial, 1 siteWaterhen Lake, SK — 1 trial, 1 siteVal-d'Or, QC — 1 trial, 1 siteTillsonburg, ON — 1 trial, 1 siteStratford, ON — 1 trial, 1 siteSmiths Crossing, NB — 1 trial, 1 siteSainte-Foy, QC — 1 trial, 1 siteSaint-Hyacinthe, QC — 1 trial, 1 siteSaint-Hubert, QC — 1 trial, 1 siteSaint-Georges, QC — 1 trial, 1 sitePort Moody, BC — 1 trial, 1 sitePenetanguishene, ON — 1 trial, 1 siteOwen Sound, ON — 1 trial, 1 siteOrléans, ON — 1 trial, 1 siteOnion Lake, SK — 1 trial, 1 siteMission, BC — 1 trial, 1 siteMiramichi, NB — 1 trial, 1 siteMira Road, NS — 1 trial, 1 siteMaria, QC — 1 trial, 1 siteLimoges, ON — 1 trial, 1 siteLa Malbaie, QC — 1 trial, 1 siteJonquière, QC — 1 trial, 1 siteHigh River, AB — 1 trial, 1 siteHawkesbury, ON — 1 trial, 1 siteHanover, ON — 1 trial, 1 siteGranby, QC — 1 trial, 1 siteEgypt — 1 trial, 1 siteDundas, ON — 1 trial, 1 siteDorchester, NB — 1 trial, 1 siteDartmouth, NS — 1 trial, 1 siteCranbrook, BC — 1 trial, 1 siteCowansville, QC — 1 trial, 1 siteCornwall, ON — 1 trial, 1 siteColumbia — 1 trial, 1 siteChâteauguay, QC — 1 trial, 1 siteChatham, ON — 1 trial, 1 siteCamrose, AB — 1 trial, 1 siteBrossard, QC — 1 trial, 1 siteBrockville, ON — 1 trial, 1 siteBrandon, MB — 1 trial, 1 siteBowmanville, ON — 1 trial, 1 siteBedford, NS — 1 trial, 1 siteBaie-Saint-Paul, QC — 1 trial, 1 siteAlliston, ON — 1 trial, 1 siteVancouverCalgaryEdmontonTorontoLondonOttawaMontréalQuébec CityIqaluitYellowknifeWhitehorseTrials per city10100800
157 Canadian cities with at least one trial site, plotted from site coordinates in the trial registry. Circle area is proportional to the number of trials in that city. Labelled centres are the eight cities the metro statistic is computed from, plus Iqaluit, Yellowknife and Whitehorse. Equidistant cylindrical projection, standard parallel 60°N — a schematic of where trials are, not a navigation chart. Province and territory outlines are Natural Earth 1:50m (public domain), simplified for size. Cities without coordinates in the registry cannot be plotted.

How far is the nearest recruiting trial?

Measured from each of Canada’s 129 largest population centres to the nearest recruiting site. We are not aware of anyone else publishing this for Canada.

Read the distribution, not the median

The median across these centres is just 2 km — but that is the finding, not a reassurance. These are the largest cities in the country, and they are precisely where trial sites cluster. The gap shows up in the tail: 15 of 129 are over 50 km away, 9 over 100 km, and 6 over 250 km.

Centres more than 100 km from a recruiting trial

CentreDistance
Iqaluit, Nunavut1,738 km
Whitehorse, Yukon1,371 km
Yellowknife, Northwest Territories1,104 km
Corner Brook, Newfoundland and Labrador462 km
Fort McMurray, Alberta401 km
Brandon, Manitoba261 km
Prince Albert, Saskatchewan174 km
Haliburton, Ontario111 km
Huntsville, Ontario106 km

What this figure cannot tell you

This measures Canada’s largest population centres only. Those are also where trial sites cluster, so the national median is small by construction and this figure understates the distance faced by smaller communities, which are not in the dataset. The distribution and the territorial figures are the meaningful signal, not the median.

How this is calculated

Straight-line (great-circle) distance from each of 129 population centres in Concord’s Canadian geography dataset to the nearest recruiting trial site, using 7,236 geocoded recruiting sites. Unweighted: each centre counts once regardless of its population, because population figures for individual centres are not in the dataset. Straight-line distance understates real travel time.

Trials by province, against population

Trial share is computed from the registry. Population share is cited from Statistics Canada, as of 1 April 2026 — the two are different kinds of number and are labelled accordingly.

ProvinceTrialsSitesTrial sharePop. shareas of 1 April 2026
Ontario1,7293,59060.5%38.9%
Quebec1,0581,99237%21.8%
Alberta67793623.7%12.2%
British Columbia55574119.4%13.6%
Nova Scotia2462608.6%2.6%
Manitoba1731986.1%3.6%
Saskatchewan1371724.8%3.1%
New Brunswick83942.9%2.1%
Newfoundland and Labrador51531.8%1.3%
Prince Edward Island330.1%0.4%
Nunavut120%0.1%
Yukon000%0.1%
Northwest Territories000%0.1%

925 Canadian site records could not be attributed to a province — the registry’s province field is free text and some entries hold a city name or a misspelling. They are excluded above rather than guessed at.

How this is calculated

Sites and distinct trials grouped by the province recorded on each site. A trial running in more than one province is counted in each, so trial shares sum to more than 100% — this is a coverage measure, not a partition. Province names in the registry are free text, so misspellings and city names in the province field are normalised; anything unrecognised is excluded and reported separately as unattributed. Population share is cited from Statistics Canada as of 1 April 2026, not computed, and is calculated against the national total so an unsourced province cannot inflate the others. Population figures: Statistics Canada, Population estimates, quarterly (Q1 2026 release), reference date 1 April 2026 — source.

Who is asking

Concord’s waitlist records people who asked to be told when a trial opens for their condition. This is stated interest from consented users — not enrolments, and not matches.

There is no demand data to show yet. Concord’s waitlist is new and currently holds 0 active sign-ups. Rather than pad this section or hide it, we are leaving it here — it will fill in as the waitlist grows, and you will be able to see exactly when it did.

How this is calculated

Counts of consented waitlist sign-ups grouped by condition and province, with small-cell suppression at the same threshold used internally (counts under 5 shown as "<5"). Stated interest from consented users — not enrolments, not matches. Counts only; no individual records are exposed.

What sits behind the gap

Concord-computed figures are marked Computed. Points drawn from elsewhere or from our own operating experience are marked Context and are not presented as our measurements.

Computed

85% of Canadian trials have at least one site in Toronto, Montreal, Vancouver, Ottawa, Calgary, Edmonton, Québec, London, and 57.6% are available nowhere else. A patient outside those cities is not choosing between trials — for most trials, there is nothing within reach.

Context

Sponsors cannot advertise trials to patients in Canada the way they can in the US. Health Canada and provincial advertising rules make direct patient-facing recruitment slow and legally fraught, so sponsors need a compliant route to reach people. This reflects Concord’s reading of the regulatory landscape, not a measurement.

Context

Opening a rural site for two participants does not pay back its setup cost. The constraint is the site-activation model itself, which is why the answer is usually decentralised visits anchored to a hub site rather than more sites.

Computed

Trial coverage does not track population. Ontario holds 60.5% of Canadian trials against 38.9% of the population (as of 1 April 2026), while the territories together hold 1 trials.

On Indigenous participation

Concord's data does not describe Indigenous participation in clinical trials, and we do not attempt to infer it. Concord is not an Indigenous-owned or Indigenous-led organisation and has no partnership with any Indigenous community, health authority, or organisation. If work in this area happens, it would be designed with communities from the start, with decisions about community data governed by the OCAP® principles — a standard we are committing to, not a credential we hold. If you work in Indigenous health and want to talk, we welcome the conversation.

OCAP® is a registered trademark of the First Nations Information Governance Centre.

Talk to us about reaching these patients

If you are running a trial, funding one, or working on rural and remote access in Canada, we would like to hear from you. No account needed.

Opens your email app. Nothing is stored on our side.

Trial data is drawn from public registry records and is only as current as the registry itself. Sites open and close during a study. Every figure on this page was computed on September 10, 2026 and will change as the corpus is re-synced — reload to recompute.

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