Patients eligible for cancer clinical trials seldom referred by physicians

Kathleen Blanchard's picture
Cancer clinical trials

Findings from researchers show few physicians refer their patients who are eligible to cancer clinical trials.

In the study, physicians most likely to refer patients were those who received financial incentive. The findings come from an analysis of data from the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS).

The study that surveyed 1533 oncologists, radiation oncologists, and surgeons caring for colorectal and lung cancer patients in 2005 found that among 8000 cancer research trials available, only 2 percent of newly diagnosed cancer patients participate in them because physicians aren't referring.

The authors 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 cancer patients, and attended weekly tumor board meetings."

The researchers say 56.7 percent of 869 physicians had referred one patient to a cancer clinical trial in the previous 12 months, two thirds of whom were associated with a Community Clinical Oncology Program or an NCI-designated cancer center.


The average number of patients by physician practice type was 17.2 for medical oncologists, 9.5 for radiation oncologists, and 12.2 for surgeons. The authors note primary care physicians have limited opportunity to discuss cancer clinical trials with patients.

The findings are limited due to physician self-reporting and small representative sampling of physicians. The authors 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."

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 in an accompanying editorial that "the American public continues to value medical research", noting that patients rely on physicians to refer or enroll them in cancer clinical trials, found in a Mayo clinic trial.

"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", conclude the study authors.

The analysis shows few patients eligible for cancer clinical trials are being referred by physicians. In the study, among 8000 trials conducted, just 2 percent of patients participated due to lack of physician guidance.

JNCI J Natl Cancer Inst (2011): doi: 10.1093/jnci/djq549
"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