BARRIERS TO PARTICIPATION IN RANDOMIZED CLINICAL TRIALS FOR EARLY BREAST CANCER AMONG AUSTRALIAN CANCER SPECIALISTS

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Abstract
Background: Doctors’ discomfort with the randomized trial process may significantly impact on accrual rates to clinical trials. However, there is little information regarding factors that influence accrual to clinical trials in Australia. The present study examines Australian cancer specialists’ attitudes towards and participation in current breast cancer clinical trials. Methods: All medical and radiation oncologists across Australia and surgeons listed as participants in the Australian and New Zealand Breast Cancer Trials Group were sent questionnaires assessing attitudes towards and participation in current clinical trials for early stage breast cancer. Results: The response rate was 71% (269/381). The mean age of respondents was 45 years and 85% were male. Respondents estimated that a mean of 5.2 (SD = 8.2) of their patients had been enrolled in a breast cancer clinical trial in the previous 12 months. Participation (in any trial) by medical oncologists (60.6%, 95%CI 54.5–66.7%) and surgeons (63.1%, 95%CI 57.1–69.1%) was significantly higher than for radiation oncologists (43.2%, 95%CI 37–49.4%, P = 0.03). The major barriers to participation in current breast cancer trials were lack of resources (44%) or issues related to specific trials (44%; e.g. relevance of the research questions or choice of standard therapies). Conclusions: The results of this study suggest that efforts to improve doctors’ participation in clinical trials need to address a number of issues. More empirical research is needed to evaluate new strategies to raise participation in clinical trials.