Barriers and Challenges to Global Clinical Cancer Research

Background. There are concerns about growing barriers to cancer research. We explored the characteristics of and barriers to global clinical cancer research. Methods. The American Society of Clinical Oncology International Affairs Committee invited 300 selected oncologists with research experience from 25 countries to complete a Web‐based survey. Fisher's exact test was used to compare answers between participants from high‐income countries (HICs) and low‐ and middle‐income countries (LMICs). Barriers to clinical cancer research were ranked from 1 (most important) to 8 (least important). Mann‐Whitney's nonparametric test was used to compare the ranks describing the importance of investigated obstacles. Results. Eighty oncologists responded, 41 from HICs and 39 from LMICs. Most responders were medical oncologists (62%) at academic hospitals (90%). Researchers from HICs were more involved with academic and industry‐driven research than were researchers from LMICs. Significantly higher proportions of those who considered their ability to conduct academic research and industry‐driven research over the past 5 years more difficult were from HICs (73% vs. 27% and 70% vs. 30%, respectively). Concerning academic clinical cancer research, a lack of funding was ranked the most important (score: 3.16) barrier, without significant differences observed between HICs and LMICs. Lack of time or competing priorities and procedures from competent authorities were the second most important barriers to conducting academic clinical research in HICs and LMICs, respectively. Conclusion. Lack of funding, lack of time and competing priorities, and procedures from competent authorities might be the main global barriers to academic clinical cancer research. 摘要 背景. 越来越多的癌症研究障碍引起了全球关注。本文探索了全球临床癌症研究的特征及其障碍。 方法. 美国临床肿瘤学会国际事务委员会从25个国家中遴选并邀请了300位具有研究经验的肿瘤科医生来完成一项网上调查。使用Fisher确切概率法来比较来自高收入国家（HIC）与低至中等收入国家（LMIC）参与者之间所提供的答案。临床癌症研究的各项障碍被分为1级（非常重要）到8级（最不重要）。通过Mann‐Whitney非参数检验来比较纳入调查的障碍的重要性等级。 结果. 80位肿瘤科医生作出应答，其中41位来自HIC，39位来自LMIC。大多数应答者为就职于学术性医院（90%）的肿瘤内科医生（62%）。来自HIC的研究者在学术研究以及产业驱动的研究方面参与程度高于来自LMIC的研究者。有显著更高比例的HIC研究者认为，在过去的5年内开展学术研究以及产业驱动的研究 所面临的困难更大（与LMIC研究者相比，分别为73% vs. 27% 、70% vs. 30%）。就学术性临床癌症研究而言，缺乏资金被列为最重要（评分3.16）的障碍，HIC研究者与LMIC研究者之间未观察到显著差异。时间不够多或相互竞争的优先级以及监管当局的审批流程分别被HIC与LMIC列为第二重要的障碍。 结论. 缺乏资金和时间、相互竞争的优先级以及监管当局审批流程可能是学术性临床癌症研究所面临的全球性障碍。The Oncologist 2014;19:1‐7 Using data from the American Society of Clinical Oncology International Affairs Committee's Web survey of selected oncolog