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 November 9, 2026 from 9,398 Canadian trial site records (9,306 with coordinates) across 2,972 trials.
Headline statistics
57.5%
of Canadian trials are available only in eight cities
1,708 of 2,972 trials
185
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 2,972 trials with at least one Canadian site.
146 Canadian cities with at least one recruiting 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
Centre
Distance
Iqaluit, Nunavut
1,738 km
Whitehorse, Yukon
1,371 km
Yellowknife, Northwest Territories
1,104 km
Corner Brook, Newfoundland and Labrador
462 km
Fort McMurray, Alberta
401 km
Brandon, Manitoba
261 km
Prince Albert, Saskatchewan
174 km
Haliburton, Ontario
111 km
Huntsville, Ontario
106 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 7,580 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.
Province
Trials
Sites
Trial share
Pop. shareas of 1 April 2026
Ontario
1,808
3,766
60.8%
38.9%
Quebec
1,110
2,092
37.3%
21.8%
Alberta
703
976
23.7%
12.2%
British Columbia
582
773
19.6%
13.6%
Nova Scotia
250
265
8.4%
2.6%
Manitoba
178
203
6%
3.6%
Saskatchewan
143
178
4.8%
3.1%
New Brunswick
88
99
3%
2.1%
Newfoundland and Labrador
53
57
1.8%
1.3%
Prince Edward Island
3
3
0.1%
0.4%
Nunavut
1
2
0%
0.1%
Yukon
0
0
0%
0.1%
Northwest Territories
0
0
0%
0.1%
984 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
85.2% of Canadian trials have at least one site in Toronto, Montreal, Vancouver, Ottawa, Calgary, Edmonton, Québec, London, and 57.5% 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 60.8% 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.
Reach — Canada’s clinical trial access gap, measured · Concord Health — clinical trials in Canada, in plain language