[Ip-health] NYT: Cigarette Co. Paid for Lung Cancer Study

[Suerie Moon]

--
[ Picked text/plain from multipart/alternative ]
Excerpts:
"The Cancer Letter, a newsletter, recently reported that Drs. Henschke and =
Yankelevitz had failed to disclose in articles and educational lectures a p=
atent and 10 pending patents related to CT screening and follow-up. General=
 Electric, a maker of CT scanners, licensed the issued patent beginning in =
2001.
 Jonathan Weil, a Weill Cornell spokesman, said Dr. Henschke did not disclo=
se the patents in some articles and lectures because she did not deem them =
relevant.
 On Monday, The Journal of the American Medical Association published corre=
ctions about unreported financial disclosures from Drs. Henschke and Yankel=
evitz. The patent and pending patents reported by The Cancer Letter =93are =
relevant to these publications,=94 an editors=92 note stated. Editors at th=
e journal were not aware of Dr. Henschke=92s association with Liggett, said=
 Dr. Catherine D. DeAngelis, the journal=92s editor in chief.
 =93I would never publish a paper dealing with lung cancer from a person wh=
o had taken money from a tobacco company,=94 Dr. DeAngelis said.
  Universities are responsible for policing conflicts of interest and, in m=
any cases, the required disclosures of their faculty. But Weill Cornell sha=
red in the proceeds of Dr. Henschke=92s patent and pending patents, and uni=
versity officials were on the foundation board.
 =93We have a very strict oversight policy=94 for conflicts of interest, Dr=
. Gotto of Weill Cornell said. He dismissed any suggestion that the univers=
ity could not police and benefit from faculty members=92 financial deals.
 But Dr. Kassirer said, =93The problem is that universities, because they=
=92re so conflicted themselves, ignore the conflicts of interest of their f=
aculty.=94 "


The New York Times
March 26, 2008
   Cigarette Company Paid for Lung Cancer Study   By GARDINER HARRIS
           In October 2006, Dr. Claudia Henschke of Weill Cornell Medical C=
ollege jolted the cancer world with a study saying that 80 percent of lung =
cancer deaths could be prevented through widespread use of CT scans.
 Small print at the end of the study, published in The New England Journal =
of Medicine, noted that it had been financed in part by a little-known char=
ity called the Foundation for Lung Cancer: Early Detection, Prevention & Tr=
eatment. A review of tax records by The New York Times shows that the found=
ation was underwritten almost entirely by $3.6 million in grants from the p=
arent company of the Liggett Group, maker of Liggett Select, Eve, Grand Pri=
x, Quest and Pyramid cigarette brands.
 The foundation got four grants from the Vector Group, Liggett=92s parent, =
from 2000 to 2003.
 Dr. Jeffrey M. Drazen, editor in chief of the medical journal, said he was=
 surprised. =93In the seven years that I=92ve been here, we have never know=
ingly published anything supported by=94 a cigarette maker, Dr. Drazen said=
.
 An increasing number of universities do not accept grants from cigarette m=
akers, and a growing awareness of the influence that companies can have ove=
r research outcomes, even when donations are at arm=92s length, has led nea=
rly all medical journals and associations to demand that researchers accura=
tely disclose financing sources.
 Dr. Henschke was the foundation president, and her longtime collaborator, =
Dr. David Yankelevitz, was its secretary-treasurer. Dr. Antonio Gotto, dean=
 of Weill Cornell, and Arthur J. Mahon, vice chairman of the college board =
of overseers, were directors.
 Vector issued a press release on Dec. 4, 2000, saying that it intended to =
give $2.4 million to Weill Cornell to finance Dr. Henschke=92s research. Ar=
ticles in Business Week and USA Today mentioned the gift. No mention was ma=
de of the foundation, begun so hastily that its 2000 tax return stated =93n=
ot yet organized.=94
 Paul Caminiti, a Vector spokesman, confirmed that the company donated $3.6=
 million to the foundation over three years. The company =93had no control =
or influence over the research,=94 he said.
 Prominent cancer researchers and journal editors, told of the foundation b=
y The Times, said they were stunned to learn of Dr. Henschke=92s associatio=
n with Liggett. Cigarette makers are so reviled among cancer advocates and =
researchers that any association with the industry can taint researchers an=
d bar their work from being published.
  =93If you=92re using blood money, you need to tell people you=92re using =
blood money,=94 said Dr. Otis Brawley, chief medical officer of the America=
n Cancer Society. The society gave Dr. Henschke more than $100,000 in grant=
s from 2004 to 2007, money it would not have provided had it known of Ligge=
tt=92s grants, Dr. Brawley said.
 In an e-mail message, Drs. Henschke and Yankelevitz wrote, =93It seems cle=
ar that you are trying to suggest that Cornell was trying to conceal this g=
ift, which is entirely false.=94
 =93The gift was announced publicly, the advocacy and public health communi=
ty knew about it, it is quite easy to look it up on the Internet, its board=
 has independent Cornell faculty on it, and it was fully disclosed to grant=
 funding organizations,=94 they wrote, adding that the Vector grant represe=
nted a small part of the study=92s overall cost. The foundation no longer a=
ccepts grants from tobacco companies, they wrote.
 In the Vector press release, Dr. Henschke was quoted as saying that, thank=
s to the Vector grants, =93we have raised the initial funding needed to sup=
port this important research and data collection on the effectiveness of sp=
iral CT screening.=94
 Dr. Gotto said in an interview that Dr. Henschke, Dr. Yankelevitz and anot=
her colleague set up the foundation initially without the university=92s ap=
proval, which he said faculty members are allowed to do. He and Mr. Mahon j=
oined the board some weeks or months after its creation to ensure that the =
Vector grants were handled correctly, he said.
 =93If we had been approached, we would not have set up the foundation,=94 =
Dr. Gotto said. =93We would have accepted the gift directly. We think we be=
haved honorably. There was no attempt to set up a foundation to hide tobacc=
o money.=94
 Days earlier, Andrew Ben Ami, assistant secretary of the foundation, said =
in an interview he would not disclose the source of the charity=92s financi=
ng at the request of the university.
 In another interview before Dr. Gotto agreed to speak, Mr. Mahon, another =
foundation director, said he did not know the source of the funds.
 Dr. Robert C. Young, chancellor of the Fox Chase Cancer Center in Philadel=
phia and chairman of the Board of Scientific Advisors of the National Cance=
r Institute, said he had never heard of the Vector grants. =93As someone wh=
o really hung around the inner sanctum of cancer research, I have never hea=
rd anybody =97 anybody =97 ever say anything about this,=94 Dr. Young said.
 Dr. Jerome Kassirer, a former editor of The New England Journal of Medicin=
e and the author of a book about conflicts of interest, said he believed th=
at Weill Cornell had created the foundation to hide its receipt of money fr=
om a cigarette company. =93You have to ask yourself the question, =91Why di=
d the tobacco company want to support her research?=92 =94 Dr. Kassirer sai=
d. =93They want to show that lung cancer is not so bad as everybody thinks =
because screening can save people; and that=92s outrageous.=94
 Dr. Henschke=92s work, while controversial among cancer researchers, has b=
een embraced by many lung-cancer advocacy organizations, which have pushed =
for legislation in California, New York and Massachusetts to create trust f=
unds to pay for lung cancer screening =97 often with language tailored to b=
enefit Dr. Henschke=92s group.
 In New York, a bill would create a $10 million fund =93to carry out lung c=
ancer early detection research using computer tomography (CT) scanning=94 a=
t a place =93that was established by the multi-institutional, multi-discipl=
inary research program that began at 22 sites in the state in the year 1991=
,=94 a description that could only fit Dr. Henschke=92s group.
  But the disclosure that Dr. Henschke=92s work was in part underwritten by=
 grants from a cigarette maker will undercut those efforts, prominent cance=
r researchers said.
 =93She=92s the biggest advocate for widespread spiral CT screening,=94 sai=
d Dr. Paul Bunn, a lung cancer expert and executive director of the Interna=
tional Association for the Study of Lung Cancer. =93And now her research is=
 tainted.=94
 Corporate financing can have subtle effects on research and lead to uncons=
cious bias. Studies have shown that sponsored research tends to reach concl=
usions that favor the sponsor, which is why disclosure is encouraged. The t=
obacco industry has a long history of underwriting research =97 sometimes t=
hrough independent-sounding foundations =97 to make cigarettes seem less da=
ngerous.
 Since 1999, Dr. Henschke has asserted that annual CT scans of smokers and =
former smokers would detect lung cancer when tumors are small enough to be =
cured, preventing as many as 80 percent of the 160,000 deaths a year from l=
ung cancer, by far the biggest cause of cancer deaths in the United States.
 Her 2006 study said that, after screening 31,567 people from seven countri=
es, CT scans uncovered 484 lung cancers, 412 of them at a very early stage.=
 Three years later, most of those patients were still alive, and she projec=
ted that 80 percent would be alive after 10 years and assumed that they wou=
ld have died without the screens.
 Critics question both her survival projections and her assumption that all=
 would have died without screening. Indeed, most in the cancer establishmen=
t say that Dr. Henschke has yet to prove her case. CT scans have radiation =
risks and sometimes detect cancers that would not have progressed, leading =
to risky procedures like biopsies and lung surgery when not needed.
 To settle the dispute, the National Cancer Institute started in 2002 the $=
200 million National Lung Screening Trial comparing death rates among 55,00=
0 people randomly assigned to have CT scans or chest X-rays. Results are no=
t expected until 2010. Dr. Henschke has asserted that allowing hundreds of =
thousands of people to die in the meantime is unethical.
 The Cancer Letter, a newsletter, recently reported that Drs. Henschke and =
Yankelevitz had failed to disclose in articles and educational lectures a p=
atent and 10 pending patents related to CT screening and follow-up. General=
 Electric, a maker of CT scanners, licensed the issued patent beginning in =
2001.
 Jonathan Weil, a Weill Cornell spokesman, said Dr. Henschke did not disclo=
se the patents in some articles and lectures because she did not deem them =
relevant.
 On Monday, The Journal of the American Medical Association published corre=
ctions about unreported financial disclosures from Drs. Henschke and Yankel=
evitz. The patent and pending patents reported by The Cancer Letter =93are =
relevant to these publications,=94 an editors=92 note stated. Editors at th=
e journal were not aware of Dr. Henschke=92s association with Liggett, said=
 Dr. Catherine D. DeAngelis, the journal=92s editor in chief.
 =93I would never publish a paper dealing with lung cancer from a person wh=
o had taken money from a tobacco company,=94 Dr. DeAngelis said.
  Universities are responsible for policing conflicts of interest and, in m=
any cases, the required disclosures of their faculty. But Weill Cornell sha=
red in the proceeds of Dr. Henschke=92s patent and pending patents, and uni=
versity officials were on the foundation board.
 =93We have a very strict oversight policy=94 for conflicts of interest, Dr=
. Gotto of Weill Cornell said. He dismissed any suggestion that the univers=
ity could not police and benefit from faculty members=92 financial deals.
 But Dr. Kassirer said, =93The problem is that universities, because they=
=92re so conflicted themselves, ignore the conflicts of interest of their f=
aculty.=94
 Legislation being considered in Congress would require drug and device mak=
ers to post registries of payments to doctors.
 An increasing number of doctors and institutions are setting up foundation=
s to accept money from companies without having to disclose its source, sai=
d Dr. Murray Kopelow, chief executive of the Accreditation Council for Cont=
inuing Medical Education.
 =93This is the third time in the past few weeks that one of these has been=
 identified to us,=94 said Dr. Kopelow, whose organization is investigating=
 how widespread the practice is.
 Laurie Fenton Ambrose, president and chief executive of the Lung Cancer Al=
liance, a nonprofit patient advocacy group, said she still trusted Dr. Hens=
chke and still believed in widespread CT scanning to prevent lung cancer de=
aths.


___________________________
Suerie Moon
Research Fellow & Phd Student
Kennedy School of Government, Harvard University
suerie_moon@ksgphd.harvard.edu