Reasons for accepting or declining to participate in randomized clinical trials for cancer therapy

This paper reports on the reasons why patients agreed to or declined entry into randomized trials of cancer following discussions conducted by clinici ans in both District General and University Hospitals. Two hundred and four patients completed a 16-item questionnaire following the consultation, of these 112 (55%) were women with breast cancer. Overall results showed that 147 (72.1%) patients accepted entry to a randomized clinical trial (RCT). T he main reasons nominated for participating in a trial were that 'others wi ll benefit' (23.1%) and 'trust in the doctor' (21.1%). One of the main reas ons for declining trial entry was that patients were 'worried about randomi zation' (19.6%). There was a significantly higher acceptance rate for trial s providing active treatment in every arm 98 (80.6%) compared with those tr ials with a no treatment arm 46 (60.5%), chi(2) test P = 0.003. The study o utlines a number of factors that appear to influence a patient's decision t o accept or decline entry into an RCT of cancer therapy. An important facto r is whether or not the trial offers active treatment in all arms of the st udy. Communication that promotes trust and confidence in the doctor is also a powerful motivating influence. (C) 2000 Cancer Research Campaign.