Identifying the gaps: Cochrane Reviews on cancer prevention

Article type
Year
Authors
Skoetz N1, Köhler N1, Goldkuhle M1, Narayan V2, Miller A3, Dahm P3
1Cochrane Cancer Alliance, University Hospital of Cologne, Department of Internal Medicine, Cologne, Germany
2Minneapolis Veterans Affairs Health Care System and University of Minnesota, Department of Urology, USA
3Cochrane Cancer Alliance, Minneapolis Veterans Affairs Health Care System and University of Minnesota, Department of Urology, USA
Abstract
Background: Cancer represents a major healthcare burden of our current time, affecting nearly 34 million individuals worldwide. Cancer is associated with disease-specific symptoms, impaired quality of life and resource utilization on an individual patient level, as well as social and economic equity on a societal level. Apart from efforts aimed at better detection and treatment, increased efforts have recently been directed towards cancer prevention (e.g. smoking cessation, tackling childhood obesity). Given Cochrane’s role in the synthesis and dissemination of reliable information on healthcare interventions, it should play an important role in this space.

Objectives: To critically assess Cochrane’s engagement in systematic reviews of cancer prevention.

Methods: We performed a systematic, protocol-driven search for cancer prevention related reviews in the Cochrane Library using a tailored search strategy (search date March 2016). We also searched the Cochrane list of priority reviews related to cancer (www.cochrane.org/news). Two authors independently screened the results and extracted data.

Results: We identified five Cochrane protocols and 19 published reviews assessing various types of cancer prevention, of which only five were published within the last three years. Eight evaluated dietary supplements, four assessed benefits and harms of drugs. The evaluation of the Cochrane priority list showed that 30/345 prioritized titles are cancer reviews (9%), but none is related to cancer prevention, and only one cancer review out of 61 prioritized published reviews has been published so far. The Cochrane Review Support Program has allocated funding to one cancer-related review (out of nine funded reviews), again, not assessing prevention but treatment.

Conclusions: Cancer prevention is an underdeveloped field for Cochrane as reflected in the relative paucity of recent and ongoing reviews in this field. Raising greater awareness for this field through activities of the newly formed Cancer Alliance, as well more robust methods for the use of non-randomized controlled in Cochrane Reviews may help enhance Cochrane’s engagement in this arena.