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Tobacco Co. Funded Lung Cancer Study Elicits Mea Culpa from New England Journal of Medicine

Apr 4, 2008 | Parker Waichman Alonso LLP

After embarrassing disclosures of financial links between the authors of a lung-cancer study and two large companies—General Electric and Vector Group, Ltd.—the New England Journal of Medicine published a correction, a clarification, and an editorial that called for the transparent disclosure of funding sources.  The lung-cancer study, which the journal published in 2006, has been controversial and suggested an annual screening with a CT scan could reduce the death rate from lung cancer, the top cancer killer.  Critics said the study revealed that screening could detect cancers earlier—not that screening could avert deaths.  GE is a big CT scanner maker and Vector is part of the Liggett Group, a large cigarette maker.

In the correction, the New England Journal acknowledges the study's lead authors, Claudia Henschke and David Yankelevitz of Cornell University's Weill Medical College in New York City, received royalties from GE for pending patents on ways to manipulate and interpret CT scans and other medical images.

In late 2006, Henschke released a study revealing that the vast majority of lung cancer deaths could be prevented through widespread use of CT scans.  The study was published in The New England Journal of Medicine and indicated—in small print at the end of the piece—the work was financed, in part, by the Foundation for Lung Cancer:  Early Detection, Prevention & Treatment.  A tax record review revealed the foundation was almost entirely underwritten by $3.6 million in grants from the Vector Group, of Liggett Select, Eve, Grand Prix, Quest, and Pyramid cigarette brands.  From 2000 to 2003, the foundation received four grants from Vector.

A spokesman for the doctors said they told the New England Journal that Cornell licensed the pending patents to GE before the study was printed, but not that they were personally receiving royalty shares.  Jeffrey Drazen, the New England Journal's chief editor, said the publication learned of the royalties recently and that the journal will ask future researchers to provide details on funding sources. "It had not been a practice at the time to ask people about the pedigree of their sources," Dr. Drazen said. "This has been a learning process for us."  The New England Journal also published a clarification from Henschke, acknowledging the study was funded, in part, by tobacco giant Vector.

In 2006, Vector announced it was funding Henschke's work, but didn't mention the connection to the tobacco industry; it claimed “no control or influence over the research."  The New England Journal called for clearer disclosure of funding sources saying readers "cannot fully appreciate a study's meaning without acknowledging the subtle biases in design and interpretation that may arise when a sponsor stands to gain from the report.  We and our readers were surprised to learn that the source of the funding of the charitable foundation was, in fact, a large corporation that could have an interest in the study results."  The journal also questioned the "advisability of research entities accepting funding from tobacco companies" except through foundations set up following litigation between states and tobacco companies.