In 2001, the National Institute for Health Research Cancer Research Network (NCRN) was established, leading to a rapid increase in clinical research activity across the English NHS.
Using colorectal cancer as an example, Professor Peter Selby and colleagues from the United Kingdom tested the hypothesis that high, sustained hospital-level participation in interventional clinical trials improves outcomes for all patients with colorectal cancer managed in those research-intensive hospitals.
Data for patients diagnosed with colorectal cancer in England in 2001–2008 were linked with data on accrual to NCRN colorectal cancer studies.
Hospital Trusts were categorized by the proportion of patients accrued to interventional studies annually.
|Increased research participation provided a reduction in postoperative mortality of almost 2%|
The research team investigated the relationship between 30-day postoperative mortality, and 5-year survival and the level and duration of study participation.
Most of the Trusts achieving high participation were district general hospitals and the effects were not limited to cancer ‘centers of excellence’, although such centers do make substantial contributions.
The researchers found that patients treated in Trusts with high research participation in their year of diagnosis had lower postoperative mortality, and improved survival after adjustment for casemix and hospital-level variables.
The team noted that the effects increased with sustained research participation, with a reduction in postoperative mortality of almost 2%, and an improvement in survival comparing high participation for ≥4 years with 0 years.
Professor Selby's team comments, "There is a strong independent association between survival and participation in interventional clinical studies for all patients with colorectal cancer treated in the hospital study participants."
"Improvement precedes and increases with the level and years of sustained participation."