Few physicians refer patients to cancer clinical trials

Feb 12, 2011

A small proportion of adult cancer patients participate in clinical trials in part due to a low level of physician referrals, according to an online study published Feb. 11 in The Journal of the National Cancer Institute.

Although more than 8000 clinical trials are accepting participants, according to the National Cancer Institute (NCI), only an estimated 2%𔃂% of newly diagnosed cancer patients participate in them. Prior studies suggest that most eligible patients do not enroll in trials because their physicians do not refer them.

To understand what types of physicians are referring their patients to clinical cancer trials, Carrie N. Klabunde, Ph.D., of NCI, and colleagues, conducted a survey-based study of specialty physicians caring for colorectal and lung cancer patients. The researchers analyzed data from the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) for 1533 oncologists, radiation oncologists, and surgeons caring for colorectal and lung cancer patients. The physicians had completed a survey during 2005-2006.

The researchers found that 869 of the physicians, or 56.7%, responded that they had referred or enrolled at least one patient in clinical trials in the previous 12 months: 87.8% of medical oncologists, 66.1% of radiation oncologists, and 35% of surgeons. Two-thirds of the physicians affiliated with a Community Clinical Oncology Program or an NCI-designated cancer center reported participating in trials.

Furthermore, the researchers write, "Those more likely to participate in a clinical trial were medical or radiation oncologists (vs surgeons), were in larger practices, had academic appointments, saw a higher volume of lung or colorectal , and attended weekly tumor board meetings."

The researchers also found that among the physicians who reported referring or enrolling at least one patient in cancer clinical trials in this period, the mean number of patients referred or enrolled was 17.2 for medical oncologists, 9.5 for radiation oncologists, and 12.2 for surgeons. The researchers note that primary care physicians have limited involvement in discussing clinical trial participation with patients; and that financial incentives were associated with physicians' clinical trials accrual volume, a finding consistent with previous studies showing financial incentives influence physician behavior.

The researchers point out certain limitations of their study: the physicians surveyed do not comprise a nationally representative sample; the study is based on physicians' self-reports of their participation in clinical trials; and the measure of trials participation combined patient referral and enrollment.

The researchers conclude that continued monitoring of physician participation in cancer clinical trials is essential. They write, "More research is needed to better understand clinician attitudes toward clinical research and to examine specific features of practice infrastructure—including availability of support staff, electronic health records, reimbursement, and clinical trial databases—that facilitate or hinder physician participation in clinical trials."

In an accompanying editorial, Lori M. Minasian, M.D., and Ann M. O'Mara, M.D., of the Community Oncology and Prevention Trials Research Group at the National Cancer Institute (NCI), write that "the American public continues to value medical research," and cite a Mayo clinic study in which 76% of patients said they expected their treating physician to inform them about .

The authors also point out that medical students will be required to learn about clinical and translational research, according to a new standard from the Liaison Committee on Medical Education.

The authors conclude: "If we want research to inform practice, we need a workforce of physicians who value the research and understand how to incorporate research results into their practice. Much of the American public looks to their to do that."

Explore further: New study helps to explain why breast cancer often spreads to the lung

add to favorites email to friend print save as pdf

Related Stories

Showing empathy to patients can improve care

Jan 24, 2011

Showing clinical empathy to patients can improve their satisfaction of care, motivate them to stick to their treatment plans and lower malpractice complaints, found a study published in CMAJ (Canadian Medical Association ...

Not all doctors follow cancer screening guidelines

Oct 14, 2010

Only one-fifth of primary care physicians in the US follow practice guidelines for colorectal cancer screening for all the tests they recommend, according to Dr. Robin Yabroff from the National Cancer Institute and her colleagues. ...

New drug uses stealth to stop cancer cell reproduction

Jan 12, 2011

A new investigational drug designed to stop cancer cells from reproducing may offer hope for patients with advanced solid tumor cancers. Clinical trials of TKM-PLK1 for qualified patients are now open at the Virginia G. Piper ...

Recommended for you

New breast cancer imaging method promising

3 hours ago

The new PAMmography method for imaging breast cancer developed by the University of Twente's MIRA research institute and the Medisch Spectrum Twente hospital appears to be a promising new method that could ...

Palliation is rarely a topic in studies on advanced cancer

3 hours ago

End-of-life aspects, the corresponding terminology, and the relevance of palliation in advanced cancer are often not considered in publications on randomized controlled trials (RCTs). This is the result of an analysis by ...

Breast cancer replicates brain development process

3 hours ago

New research led by a scientist at the University of York reveals that a process that forms a key element in the development of the nervous system may also play a pivotal role in the spread of breast cancer.

User comments : 0

More news stories

Team reprograms blood cells into blood stem cells in mice

Researchers at Boston Children's Hospital have reprogrammed mature blood cells from mice into blood-forming hematopoietic stem cells (HSCs), using a cocktail of eight genetic switches called transcription factors. The reprogrammed ...

Cell resiliency surprises scientists

New research shows that cells are more resilient in taking care of their DNA than scientists originally thought. Even when missing critical components, cells can adapt and make copies of their DNA in an alternative ...