Nature and extent of financial conflicts of interest among National Comprehensive Cancer Network (NCCN) clinical practice guidelines panel members.

Abstract

e16555 Background: NCCN Clinical Practice Guidelines are the most widely recognized and comprehensive clinical policies used in oncology written by multidisciplinary panels of expert physicians from NCCN member institutions. However, the recommendations are largely developed from lower levels of evidence or expert opinions, and therefore, potentially vulnerable to influence by financial conflicts of interest (FCOIs) (Poonacha T, et al. J Clin Oncol 2011;29:186-191). Objective: We performed this study to describe the nature and extent of self-reported FCOIs of NCCN panel members among the 10 most common cancers in the US. Methods: We obtained the disclosures from the NCCN website (accessed December 1, 2011). FCOIs are reported under 4 categories: clinical research support (research), advisory board/speaker bureau/expert witness/consultant (honoraria), patent/equity/royalty (equity), and other remunerations. Results: There are 330 panel members with a mean of 33 per panel. Most (94%), but not all, disclosures are up to date as of 2011. 141 (43%) panel members reported FCOIs. The extent of FCOIs among panel members according to disease sites are as follows: non-Hodgkin lymphoma (60%), breast (52%), kidney (49%), colorectal (48%), lung (47%), prostate (41%), bladder (40%), melanoma (29%), thyroid (28%), and uterine (25%) cancers. 74% (n=23) of writing committee members and 83% of panel chairs have FCOIs. Among the panel members with FCOIs, 51%, 48 %, 1%, and 1% of the FCOIs are related to research, honoraria, equity, and other remunerations, respectively. Of those with non-research FCOIs (n=109), 38%, 29%, and 33%, reported 1, 2-3, and >4 disclosures, respectively Conclusions: ASubstantial proportions of NCCN panel members as well as the majority of panel chairs and writing committee members have FCOIs. Nearly half of the FCOIs are unrelated to research support. While the actual impact of FCOIs on the NCCN recommendations cannot be determined from our study, the potential for such influence can be considerable.