Leeds: Bowel cancer patients are more likely to survive if treated in hospitals where lots of clinical research is taking place - even if they themselves are not involved in trials, a study has found. More people survived operations in
these types of hospitals and patients were also more likely to still be alive
when followed up five years afterwards, the University of Leeds researchers discovered.
In fact, there was a nearly four per cent increase in the
five-year survival rate for those treated in highly research-active hospitals.
“It's important to note that these improved outcomes were
seen across all bowel cancer patients within these hospitals and not just those
in the clinical trials,” said Dr Amy Downing, a senior research fellow at the
University of Leeds, and lead author of the study.
“We think that being more involved in research leads to
better protocols, improved knowledge and better-trained staff, and this
benefits the whole patient population.”
Co-author Matt Seymour, Professor of Gastrointestinal Cancer
Medicine at the University of Leeds, added: “The effects may seem small - just
a few per cent - but for a cancer that affects over 40,000 people in the UK
every year a few per cent means a lot of lives.
“We have long known that clinical research is crucial for
discovering better treatments to help future generations of patients, but this
study tells us something new.
“It shows that, by getting involved in research trials,
hospitals may 'up their game' and provide better care for all the patients they
treat even in the short term, long before the results of those trials are
known.”
For the study, which is published today in the journal Gut,
the researchers looked at data from 209,968 patients diagnosed with bowel
cancer in England between 2001 and 2008.
The hospitals treating these patients were then split
according to the percentage of patients taking part in clinical trials; those
with more than 16 per cent of bowel cancer patients involved in trials over the
course of a year were classed as having high research levels that year.
The researchers found that death rates in the first 30 days
after surgery were 6.5 per cent, and 41 per cent of bowel cancer patients were
still alive five years after their initial diagnosis, in hospitals with zero
years of high-research participation.
But death rates after surgery dropped to five per cent, and
44.8 per cent of patients survived for more than five years, in hospitals with
four or more years of high-research participation (i.e. 16 per cent or more
patients involved in clinical trials a year, for four of the years between 2001
and 2008).
Most of the hospitals conducting high levels of research
were district general hospitals and the effects were not limited to cancer
‘centres of excellence’, said Peter Selby, Professor of Cancer Medicine at the
University of Leeds and co-author of the study.
“Our results allow investigators to show patients,
healthcare commissioners and policymakers that being treated in a hospital
active in clinical research is strongly associated with better outcomes for
bowel cancer patients,” Professor Selby concluded.
“The data provide an additional incentive to integrate
research into standard medical care.”
Professor Peter Johnson, chief clinician for Cancer Research
UK, said: “It’s crucial that NHS Trusts are involved in research and offer
patients all possible opportunities to participate.
“To achieve this, clear leadership is needed. This is why
NHS England needs to publish a plan for how it will deliver on its duty to
promote and support research in the NHS.”
Charles
Rowett, chief executive of Yorkshire Cancer Research, which helped fund the
research, said: “This paper provides concrete evidence of the importance of our
extensive investment in bowel cancer research in Leeds.
“Despite having higher cancer incidence and mortality rates
than many other areas of England, Yorkshire has historically not received
sufficient funding to address the specific problems that exist in our region.
“We would urge all national and regional cancer research
charities, the government and the NHS to work together so that everybody can
benefit from the proven advantage of living close to research active
hospitals.”
Health minister Lord Prior, whose
policy areas include academic health research and the Cancer Drugs Fund, also
welcomed the finding:
“I am proud of the world-leading clinical research taking place in our
hospitals which appears to also be having a positive impact on the lives of
people suffering from bowel cancer," he said.
“The fact that even patients at research-active hospitals who
aren’t on clinical trials have better outcomes demonstrates the hugely powerful
benefit of research in all aspects of healthcare.”
The trial data that the study used was from the National
Institute for Health Research’s Clinical Research Network.