Tobacco Stains Scientists' Integrity
by Adam Clark (LIVESTRONG Staff)7 Comments
Integrity is the foundation of good science. It is needed to ensure the public’s trust and the lack of it becomes a danger to the public’s welfare. This is especially true in medical science, where a conflict of interest may lead to approval of a drug or technique that is potentially harmful to the patient. And whether a conflict of interest is real or perceived, it has serious repercussions to advancing medical science. This is why an article published yesterday in the NYT and elsewhere that showed that a group investigating lung cancer screening technologies was funded by a tobacco company was particularly troubling to read. While the researchers’ best intentions may have been to improve lung cancer survival, their actions in accepting the tobacco company’s money as the primary funding agent have caused their results to be scrutinized, their credibility to be questioned, more conflicts of interest to be exposed, and ultimately hindered an already daunting task of improving lung cancer screening.
Lung cancer is the leading cause of cancer-related deaths in the US, and like all cancers, has a much higher survival rate when caught early. A major challenge to improving survival has been that we do not yet have approved screening technologies to catch it at its earliest stages.
On the positive front an imaging technique called “spiral CT” has been able to identify early stage lung tumors. It is currently being examined by the NCI’s National Lung Screening Trial as a potential technology to catch lung cancer at its earliest stages, particularly in high risk individuals like smokers and former smokers. If proven to be successful in improving mortality, spiral CT could move into the arsenal of early detection techniques that include pap smears, mammographies, and colonoscopies.
Until recently, the major arguments regarding spiral CT have surrounded whether the technology actually saves lives and improves mortality from lung cancer. But, unfortunately, the answer is not as easy to determine as it seems. Both sides can make an argument that they are addressing the needs of the public health. Advocates for the trial have argued that the low-dose radiation and potential invasive techniques such as biopsies are risks that may ultimately cause more harm to patients. While proponents of spiral CT screening have argued that the imaging technique has identified early stage tumors and that the trial is not moving fast enough to get this screening approach approved.
Hence, why these researchers’ relationship with a tobacco company is so harmful; the investigators have argued for approval of this technique as a highly successful screening technology. But by accepting money from tobacco companies, their integrity has been tainted and their recommendations for approval of spiral CT have been questioned. So while they may have had good intentions and tried to be transparent, their actions have hindered progress.
As a cancer biologist with a background in early detection technologies, I have been a staunch proponent of imaging. It works in many types of cancers and it is only going to get better. We need more funding in this area and we need to find a better system to move these technologies through an approval process. But in this case, accepting the funding from tobacco was the wrong mechanism to support this research.
However, it is my hope that the research community can get over this set back and redouble their efforts on evaluating this technology. It is more important now to focus on improving funding for early detection technologies and finding better ways to evaluate, assess, and deploy these technologies to improve survival.
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