Its okay to smoke…we’ll screen you

Commentary by Shrujal Baxi MD, NYU Chief Resident

One of the first things you learn about critically analyzing a medical journal piece is to go to the end and see who sponsored the study. Corporate financing is known to have subtle effects on research which can lead to an unconscious bias. Disclosure of funding is paramount for a researcher in order to remain above reproach.

In a recent New York Times article, the impact of such relationships is investigated. In 2006, Dr. Claudia Hensheke, a radiologist at Weill Cornell Medical Center, reported that 80% of deaths due to lung cancer could be prevented through widespread use of screening spiral lung CT scans. Although this claim raised a great deal of debate by those in the field, nothing has been more controversial than the revelation that funding for her research came directly from tobacco giant, Liggett.

Well, “directly funded” is a misnomer. The researchers at Cornell received funding from a little known-charity called the Foundation for Lung Cancer: Early Detection, Prevention & Treatment. This foundation was underwritten almost entirely by Vector, the parent company of the Liggett group, maker of Liggett Select, Eve, Grand Prix, Quest and Pyramid cigarette brands. At a time when universities are turning away tobacco money and journals are actively screening studies completed using such funding, it was surprising to many to hear about this undisclosed contribution. The article goes into detail about the relationship of the faculty involved at Cornell and the foundation funding the research with speculations about intent to hide their financial information.

Whether or not lung cancer screening is adopted as routine practice remains to be seen. There are many on-going studies pending attempting to answer just that, but you can be sure that funding of future studies will be heavily scrutinized before results are made available. As for the faculty at Cornell, regardless of their motivation and actions, a larger question was raised by this situation: If universities are held responsible for policing conflicts of interest and disclosure of their faculty, then who is policing the universities?

The subtle message sent by this trial is that screening CT scans can some how prevent death from lung cancer. There is no question about the conflict of interest raised in this situation. The tobacco companies, who funded the study, and the patent holders of the technology, the researchers, have a great deal to gain if the results of this study are actually true.

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