Continuing disclosures of scientific misconduct in an international study of breast cancer shake confidence in the medical research Establishment. And they are profoundly upsetting to millions of women and their doctors who have relied on the two-decade-long study's key, and very welcome, conclusion: that early cancer can be just as effectively treated by a lumpectomy and radiation as by a full mastectomy.
The National Cancer Institute, which funds the study, has assured the public that the falsifications do not alter the central findings and that such therapy remains valid. But the NCI took extraordinary action Tuesday by forcing the ouster of Dr. Bernard Fisher of the University of Pittsburgh as coordinator of 14 major cancer studies involving tens of thousands of patients in the United States and Canada. It also ordered a temporary halt to enrolling new subjects in the studies, which include trials of tamoxifen, a new drug considered to have high promise.
Earlier this month it was disclosed that a researcher at St. Luc Hospital in Montreal, Dr. Roger Poisson, had altered background data on 100 women in the original breast cancer study. Then Monday came another jolt: that a "discrepancy" had been found in files of another Montreal hospital in the study, St. Mary's, and that the dossiers of all 200 subjects there were being audited. In both cases, the NCI said that Fisher, 75, a pioneer in cancer research, and his staff had been sluggish in following up on the reported falsifications and in publishing corrected data.
Cheating in research is not new and, by its nature, is hard to detect. But modern pressures for results and publication to justify more grants have encouraged it. Poisson, for example, altered dates on which women's cancers were detected to meet the required number of women called for in the study. Scientists say dishonesty is rare, but there is evidence that too-trusting hospitals, universities and government agencies have been lax in detecting misconduct.
Difficulties compound when it comes to broad cooperative studies like the NCI one, which involved more than 5,000 researchers at nearly 500 hospitals in two countries. How many other similar studies have been compromised over the years? How many drugs and other therapies in use today are based on at least partly flawed data? How can researchers be better audited?
Those are difficult questions that leaders of the National Institutes of Health must ponder when they analyze the tainted breast cancer research. So must Rep. John D. Dingell of Michigan when he holds hearings April 13. Let not politics interfere with science, but let not science interfere with truth.