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Why Patients Don’t Enter Clinical Trials: Lancet Oncology Publishes Meta-Analysis

Most common barriers to trial participation include concerns with the trial setting, dislike of randomization, discomfort with the research process, complexity and stringency of the protocol, presence of a placebo or no-treatment group, potential side effects, being unaware of trial opportunities, the idea that trials are inappropriate for serious diseases, fear that trial involvement would negatively affect the relationship with their physician, and their physician’s attitude to a trial.

Authors, including Dr. Edward J. Mills, department of clinical epidemiology and biostatistics at McMaster University in Ontario, Canada, conducted a meta-analysis and systematic review of 12 qualitative and 21 quantitative studies assessing patient barriers to participation in trials. The article appears in the February 2006 issue of Lancet Oncology. Knowing why patients are reluctant to participate in trials should help physicians and clinical researchers address these concerns, authors said.

Survey: Are Hematologic Cancer Patients Underreferred to Trials?

More than half of hematologic cancer patients seen by a hematologist or oncologist say that their specialist did not inform them about the possibility of participating in a clinical trial. This finding comes from a survey commissioned by the Leukemia & Lymphoma Society (LLS). Physicians were less likely to direct patients over age 75 to trials, with 74% of those respondents stating that their specialist did not discuss clinical trial participation. More than 60% of women, and nearly 50% of men, said they did not talk with their specialist about trial participation. About 25% of those not informed about trials said they would have wanted that information.

Brookdale Center on Aging of Hunter College and Bellevue-Hunter School of Nursing conducted the survey for LLS last fall. LLS’s goal was to determine how to improve access to, and quality of, health services for hematologic cancer patients from underserved segments such as older patients and women.

Helping Cancer Patients Understand Clinical Trials

The largest radiation oncology society in the world, The American Society for Therapeutic Radiology and Oncology (ASTRO), has published a new patient information brochure entitled Understanding Clinical Trials: Facts to Help Patients Make an Informed Decision. Louis Harrison, MD, chair of the ASTRO Communications Committee and a radiation oncologist at Beth Israel Medical Center, said, “Unfortunately, many patients do not participate in these vital trials because they don’t know enough about these studies or how to participate. With this brochure, we hope to give patients the facts they need to decide whether a clinical trial is right for them.” Clinical trials are important for patients looking for improved treatment and new ways to prevent and detect cancer.