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A leading cancer epidemiologist has heavily criticised the funding and science of a report that compares different rates of cancer survival in 25 countries. The report linked cancer survival with access to new and innovative drugs.
The Karolinska 2 report, published earlier this year in the Annals of Oncology, concluded that access to cancer drugs affected survival and that the licensing process should be speeded up, with equitable access for all (2007;18(suppl 3):iii2-7).
But the epidemiologist Michel Coleman, who heads the cancer survival group of Cancer Research UK, has in the latest issue of the same journal questioned the credibility of the figures and methods used to arrive at these conclusions (2007;18:1433-5).
He says that estimates rather than actual survival rates were used. And the benefits of access to drugs were calculated using data for about 2003 but for patients who were diagnosed between 1990 and 1994, and the research concentrated on drugs that were not available at that time.
“The authors have drawn tough conclusions. But if the methods are badly flawed, you can't [do that]. The report doesn't stand up,” Professor Coleman told the BMJ.
Contrary to what the report implies, he added, “For many adult malignancies, drugs are not the most important element of cancer survival.”
And he doubted that Roche Pharmaceuticals, which funded the research through an unrestricted educational grant, would have backed it if the “wrong conclusions” had been reached.
In a statement, he said, “This is . . . invited research, designed to answer a question that is unlikely to be of much interest to a scientist, but is obviously of interest to a company established to generate returns to its shareholders.”
But a spokeswoman for Roche said that the company “has had no involvement in the analysis of data nor did it have any input into the report's findings.”
She added that the report was in line with other findings. “The suggestion that the United Kingdom lags behind Europe in terms of cancer survival is not new and has been reiterated in the recent publication of Eurocare 4 [Lancet Oncology 2007;8:773-83],” she said.
In the same issue of the Annals of Oncology, the report's authors, Bengt Jonsson, of the Stockholm School of Economics, Nils Wilking, of the Karolinska Institute, and Franck Lichtenberg, of the University of Columbia, New York, strongly refute any interference by drug companies in their research (pp 1585-7).
Dr Wilking told the BMJ that Professor Coleman had focused on “a very minor part” of the report. “We feel there is a political agenda behind this,” he said.
“We used the data that were available,” he explained, adding that their method of survival analysis had already been used for HIV and cancer.
“Surgery and radiotherapy may have an impact on quality of life, but they don't affect survival. Drugs, early detection, and how care is organised, do,” he said