A recent survey found that over 43% of surveyed doctors did not refer or enroll a patient to a clinical trial during the preceding year, scientists at the National Cancer Institute reported in the Journal of the National Cancer Institute (JNCI). Their findings add more compelling evidence that lack of doctor participation is a key factor in low clinical trial participation among cancer patients.

The researchers explained as background information that:

“Clinical trials have long been recognized as the definitive way to identify efficacious treatments and to understand the risks and benefits of those treatments. Unfortunately, only a small fraction of cancer patients participate in clinical trials and limited information exists regarding the profile of physicians who recruit patients onto trials and the clinical practice settings in which they work.”

Carrie Klabunde, PhD. and team carried out a population-based assessment of 1,533 specialized doctors who recruit and refer their patients to clinical trials. Their study reveals what type of physicians are more likely to recruit their patients to trials in a subset of medical institutions that are already involved in clinical research.

The 1,533 specialists who participated in the Cancer Care Outcomes Research and Surveillance Consortium included medical oncologists, surgeons and radiation oncologists who had colorectal or lung cancer patients.

The authors revealed that a mere 56.7% of medical professionals in their survey referred/enrolled at least one patient to a clinical trial within the preceding 12 months of being asked. The 2005-2006 survey had a response rate of 61%.

More specifically, they found that during the preceding twelve months:

  • 87.8% of medical oncologists had referred or enrolled at least one patient to a clinical trial
  • 66.1% of radiation oncologists had referred or enrolled at least one patient to a clinical trial
  • 35% of surgeons had referred or enrolled at least one patient to a clinical trial

Health care professionals who are involved in teaching or work in a hospital-based practice are much more likely to enroll or refer their cancer patients compared to those in an office-based practice, the authors explained.

Those who are affiliated to a clinical oncology program or a national cancer center are also more likely to refer their patients compared to doctors who aren’t. Even among these physicians, only approximately two-thirds referred or enrolled patients.

Klabunde added that their study used self-reported data.

The researchers say that ways strategies are urgently needed to significantly improve cancer patient participation rates.

Such barriers as lack of compensation should be addressed, Lori Minasian, PhD, and Ann O’Mara, PhD, of the National Cancer Institute wrote in an Accompanying Editorial. Managing patients involved in clinical trial involves more work for doctors.

They added:

“Not every physician should be expected to actively accrue patients onto clinical trials, but all physicians should understand the value of clinical trials and know how to refer patients. If we want research to inform practice, we need a work force of physicians who value the research and understand how to incorporate research results into their practice.”

“A Population-Based Assessment of Specialty Physician Involvement in Cancer Clinical Trials”
Carrie N. Klabunde, Nancy L. Keating, Arnold L. Potosky, Anita Ambs, Yulei He, Mark C. Hornbrook and Patricia A. Ganz
J Natl Cancer Inst (2011) doi: 10.1093/jnci/djq549

Written by Christian Nordqvist