Certain Physicians Are More Likely to Refer Patients to Clinical Trials
According to a survey-based study of more than 1,500 physicians treating patients with lung or colorectal cancer, medical oncologists were the most likely and surgeons the least likely to refer patients to, or enroll them in, clinical trials. The study, published online February 11, 2011, in the Journal of the National Cancer Institute, evaluated the characteristics of specialty physicians who refer patients to clinical trials, the types of trials in which they participate, and factors associated with physicians who report greater involvement in clinical trials.
Almost 88 percent of the medical oncologists who participated in the survey referred or enrolled one or more of their patients in the previous year, compared with 66 percent of radiation oncologists and only 35 percent of surgeons. Nearly half of the survey respondents were affiliated with NCI’s Community Clinical Oncology Program (CCOP) or an NCI-designated Cancer Center, yet one in three of these physicians reported no enrollments or referrals in that year.
“The role of physicians in recruiting patients to clinical trials is pivotal,” wrote Carrie Klabunde, Ph.D., an NCI epidemiologist who led the study within the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) in collaboration with her colleagues. These trends reflect opportunities to improve clinical trial recruitment.
Although surgeons had the lowest rate of patient referral or enrollment, they represented more than half of the group that was surveyed. Surgical oncologists and surgical subspecialists (thoracic and other types) were much more likely than general surgeons to refer or enroll patients. Female surgeons and those over age 60 were also more likely to refer or enroll patients.
When medical oncologists or radiation oncologists received monetary incentives, they referred or enrolled 20 percent more patients. Physicians who teach medical students or residents, or who are affiliated with a CCOP or an NCI-designated Cancer Center, were also substantially more likely to refer or enroll patients. In these groups, physicians who saw more than 19 patients per month or who attended weekly tumor board meetings were much more likely to refer or enroll patients.
“Realizing the full potential of clinical research in the 21st century will require…efforts to address the complex factors that shape cancer care in the United States,” wrote the authors. “More research is needed to better understand clinician attitudes toward clinical research and to examine specific features of practice infrastructure…that facilitate or hinder physician participation in clinical trials.”