Decisions about cancer treatment are being hindered by the reluctance of some pharmaceutical companies to publish crucial clinical trial data or, in some cases, to even register their trials in the first place. Up to a quarter of cancer clinical trials are not published and are “being left to gather dust” (Independent, 08 Sept 2004), claimed Richard Sullivan, of Cancer Research UK, at the annual British Association Festival of Science.

Sullivan went on to explain, “The medical community needs to know the results of clinical trials to be able to view the entire picture of how a treatment works, how it compares to other therapies and what choices could serve patients best” (http://news.bbc.co.uk, 07 Sept 2004). Selective reporting further compounds the problem; by favouring positive results, investigators and journal editors could “distort medical literature and leave doctors thinking a treatment is more effective than it actually is” (http://news.bbc.co.uk, 07 Sept 2004).

Moreover, as Fran Balkwill commented in a Cancer Research UK press release, “If the results from trials never reach the public domain researchers could waste time and unknowingly repeat lines of inquiry that have already been proven unsuccessful”.

The problem is partly due to the disparity between public and private interests. Drug companies are disinclined to publish results that could place financial interests at risk, although these very results might help in the planning of cancer treatment.

Sullivan's comments are certainly timely, with an editorial in the New England Journal of Medicine (16 Sept 2004) also calling for all trials to be registered to facilitate full transparency with respect to clinical trial reporting.