Lung Cancer Screening Trial Financed by Tobacco-Funded Foundation, Sparks Debate

Abstract

F or those who are worried about conflicts of interest in medical research, the news that a cigarette company helped fund a major lung cancer screening study, revealed in a front page story in the New York Times and in the Cancer Letter , represented a perfect storm of ethical issues that could further erode public confidence in the value of academic science. The story highlighted how two discrete issues that research institutions grapple with — fi nancial confl ict of interest and use of tobacco company money to fund research — came together in a highly unusual way, complicating the inter pretation of results from internationally known re searchers and a major medical institution. The Times and the Cancer Letter reported that Weill Cornell Medical College researchers Claudia Henschke, M.D., Ph.D., and David Yankelevitz, M.D., its dean, Antonio Gotto, M.D., D.Phil., and the vice chairman of the college board of overseers, Arthur J. Mahon, were offi cers of a charity called the Foundation for Lung Cancer: Early Detection, Prevention, and Treatment. That charity was almost exclusively funded by $3.6 million in funds donated by the Vector Group, the holding company for Liggett Tobacco, which makes several different brands of cigarettes. Henschke and Yankelevitz used the funds as seed money to help launch studies to test whether computed tomography (CT) screening of patients at risk for lung cancer can lead to early detection of the disease. Published studies from the group have shown a connection between CT screening and improved detection, and results from the Cornell-led International Early Lung Cancer Action Program (I-ELCAP), published in the New England Journal of Medicine in 2006, demonstrate that CT screening saves lives, according to Henschke. The fi ndings created controversy among lung cancer researchers, some of whom said that the nonrandomized study did not prove that such screening could reduce mortality. But the connection between Liggett Tobacco and the researchers was not transparent in the journals that published results of I-ELCAP and earlier studies. The foundation was listed as one of 32 funding sources in the NEJM publication, but not the fact that it contained Liggett Tobacco funds and little else.