Increasing patient participation in cancer trials

What stops people with cancer from joining research trials, and ways to increase participation are the subjects of the latest publication from CRD.

Clinical trials are an essential tool for the evaluation of medical technologies. It is crucial that enough participants are recruited to a trial to ensure that the trial can proceed and for the results to be valid. Without sufficient numbers of people taking part, the introduction of new treatments or detailed evaluation of existing ones, could be delayed.

In 2000, the NHS Cancer Plan set the target of doubling the total proportion of cancer patients entering clinical trials within three years. This target was met by 2004, when almost 11% of people with newly diagnosed cancer participated in trials. However, this remains a small proportion of all cancer patients.

There is clearly a need to understand why both health professionals and patients may be reluctant to take part in trials of cancer treatments, and also to assess how effective different strategies are in overcoming such reluctance. Two systematic reviews were commissioned by the National Cancer Research Network (NCRN) and undertaken by reviewers at CRD. The reviews found:

• Existing research fails to identify in a clear, reliable and consistent way the reasons for not participating in cancer trials. However, themes were identified around which questions can be asked by those planning trials, to help improve participation rates. The involvement of patients and health professionals when identifying potential obstacles to participation could be beneficial.

• Few interventions were shown to improve participation in trials. There is a clear need for further research into the range of strategies that might increase participation. Ways to overcome obstacles also need to be developed and high quality research undertaken to assess how well they actually work.