Tobacco Assessment in Actively Accruing National Cancer Institute Cooperative Group Program Clinical Trials

Abstract

Most actively accruing cooperative group clinical trials do not assess tobacco use, and there is no observable trend in improvement over the past 8 years. Failure to incorporate standardized tobacco assessments into NCI-funded Cooperative Group Clinical Trials will limit the ability to provide evidence-based cessation support and will limit the ability to accurately understand the precise effect of tobacco use on cancer treatment outcomes.

Cigarette Smoking, Physical Activity, and Alcohol Consumption as Predictors of Cancer Incidence among Women at High Risk of Breast Cancer in the NSABP P-1 Trial

“…A shortcoming of P-1, typical of trials in cancer prevention and treatment, is that follow-up tobacco use data were not collected. The increasing evidence of the clinical impact of tobacco use on cancer prevention and prognosis across a range of disease sites warrants more widespread assessment in clinical trials than has typically been conducted (10, 29, 44–47). Biochemical validation of smoking status was not conducted in P-1.…”

Addressing Tobacco Use in Patients With Cancer: A Survey of American Society of Clinical Oncology Members

“…[18][19] Tobacco assessment and cessation are also not addressed in cooperative group clinical trials supported by the National Institutes of Health. 20 In a recent large survey of thoracic oncology providers, 90% of respondents believed that tobacco cessation is an important part of cancer care, but most did not routinely provide cessation support. 21 The purpose of this study is to report patterns of tobacco use assessment and cessation support by ASCO members and to identify perceptions of tobacco use as well as barriers to implementing cessation support for patients with cancer.…”

Reducing Tobacco-Related Cancer Incidence and Mortality: Summary of an Institute of Medicine Workshop

“…Unfortunately, many clinicians-including primary care providers, nurses, and oncologists-are reluctant to identify and address tobacco use by their patients [56,59,60]. Oftentimes, patient tobacco use status is not assessed in clinician encounters, and many clinicians do not refer patients to cessation programs.…”

“…Improving the capacity for rapid research to assess the use and health effects of new tobacco products is needed, as well as providing more funding for research on lung cancer and tobacco cessation treatment.To better understand the impact of tobacco use and cessation on cancer treatment, all cancer clinical trials could include measures to assess tobacco use and cessation [59,89]. In addition, research could maximize the impact of FDA oversight by informing product standards and other regulations.…”