Share

Reluctance to try investigational treatment, insurance denials keep patients from clinical trials

UC Davis Cancer Center study identifies patient, physician barriers to participation

(SACRAMENTO, Calif.) — Many cancer patients decline to participate in clinical trials because they do not want to use investigational treatments, even though studies indicate patients who enroll in these studies have better outcomes, according to researchers at the UC Davis Cancer Center.

Primo Lara, an assistant professor of medicine at the UC Davis Cancer Center and lead author of the study, will present his findings at the annual meeting of the American Society of Clinical Oncology in San Francisco on Sunday, May 13.

Advances in cancer treatment depend on carefully controlled studies of new treatments, yet only two to four percent of cancer patients nationwide take part in them.

In the UC Davis study, almost half of the 76 cancer patients whose doctors recommended they take part in a study and who met eligibility criteria opted not to.

Thirty-four percent said they wanted other treatment, either because they wanted more control over the process, they were wary of investigational treatments or they preferred to use alternative medicine. Thirteen percent declined because they felt they lived too far from the cancer center and eight percent said no because their private insurance denied coverage for costs associated with clinical trials.

But barriers to clinical trials extend beyond patients. Doctors declined to refer 38 percent of the surveyed patients to clinical trials, thinking that no trials were available or that their patients were too sick to be accepted. However, more than 150 clinical trials were available during the study period. It was possible some of the excluded patients would have been eligible, Lara said.

"Cancer clinical trials are essential for improving treatment and prolonging the lives of people with cancer," said Lara. "The barriers to participation we’ve identified could be reduced through patient education about the value of clinical trials."

"Doctors can do a lot to assuage their patient’s concerns by talking to them about the process," he added.

The overall enrollment rate for patients in this study was 14 percent, well above the national average but on par with accrual rates for major medical centers and teaching hospitals.

Understanding why so few patients participate in clinical trials is the first step to reversing the trend, Lara said.

A common misconception about clinical trials is that patients are volunteering for treatments that may not work. In reality, Lara said, many investigational treatments are at least as effective as conventional therapy when they are tested on cancer patients in clinical studies.

At the same time, previous research has shown that cancer patients who participate in clinical trials frequently have higher survival rates.

The problem of insurance reimbursement is more problematic, said Lara, and should be addressed through legislation. In the UC Davis Cancer Center study, patients with private health insurance were less likely to take part in cancer clinical trials than those with government insurance.

Private insurers routinely deny coverage of routine medical care to cancer patients enrolled in clinical trials.

Lara’s study was published in the March 13 issue of the Journal of Clinical Oncology. Partial funding was provided by an American Cancer Society clinical research training grant awarded to Lara in 2000.

Share

AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.