Imperial Cancer Research Fund and The Lancet
Authors: Paul Nurse, Director General
Journal: The Lancet (1997)

Richard Horton, in his Oct 11 Commentary,1Horton R ICRF: from mayhem to meltdown.Lancet. 1997; 350: 1043-1044Summary Full Text Full Text PDF PubMed Scopus (4) Google Scholar under the inappropriate and misleading headline “ICRF: from mayhem to meltdown”, makes a series of unjustified allegations against the Imperial Cancer Research Fund. In 1994 the Charities Commissioners offered guidance to the medical research charities that they should not only check the quality of publications based on research that they fund, but also ensure that important work is disseminated in an appropriate way. In respect of the Collaborative Group on Hormonal Factors in Breast Cancer's report (Oct 11, p 1047)2Collaborative Groupon Hormonal Factors in Breast Cancer. Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52 705 women with breast cancer and 108 411 women without breast cancer.Lancet. 1997; 350: 1047-1059Summary Full Text Full Text PDF PubMed Scopus (2504) Google Scholar on the effects of hormone replacement therapy (HRT) on the incidence of breast cancer, this required introducing the results responsibly into the public domain. It was the role of the director of clinical research Peter Selby, working through the chairman of the ICRF prevention and control grouping Jack Cuzick, with the authors of the paper, to ensure that this was carried out satisfactorily. We worked hard to achieve those goals and, judging by the subsequent responsible media coverage, we succeeded. The publication was, we judged, one with a particular risk of causing public anxiety and distress. To keep these to a minimum we worked closely with the Department of Health, the Chief Medical Officer, and the chairman of the Committee on the Safety of Medicines. Because of the sensitivity of the issue, we took additional advice so as to ensure a proper and balanced content to our public presentation by consulting one of the paper's authors, Richard Doll. He was involved, with Richard Peto, in drafting the news release, in consultation with the senior author Valerie Beral, and they both participated in the news conference panel, together with another author, Gillian Reeves. The aim was to minimise anxiety and distress, not to increase our fundraising profile; this is not merely an assertion but is a matter of record, as follows. In a letter to Beral on Sept 11, following the meeting with Doll, Selby wrote: “We … all recognise that there is a genuine concern that the publication of these data will promote serious anxiety among women who have been taking HRT and that we should do our utmost to keep this to a minimum and to ensure thorough briefing and good communication with the Health Departments and general practitioners…. We do not see this as a platform for fundraising or increasing the ICRF profile”. Furthermore, in a briefing note to all senior interested parties Selby recorded, on Oct 1, “ICRF policy is to take a cautious and responsible line and try to do everything we can to minimise the anxiety and distress that might be caused to women who have been taking HRT and everything that we can do to ensure that these women and their medical advisers have access to a good interpretation of the research paper…. It is not ICRF policy to seek to enhance our profile or achieve any fundraising advantage from the publication of this paper”. We informed the Department of Health of our concerns, invited their representatives to the news conference, and adopted the Committee on the Safety of Medicines' views and guidance in the wording of our news release. It is against this background that the following allegation made by Horton should be considered. Horton writes that “decisions have been driven by greed for publicity and the fundraising image of ICRF seems to have become the charity's over-riding priority”. This is contrary to the facts and is irresponsible for an influential journal of The Lancet's standing. With respect to the Sunday Times article, I am completely in sympathy with Horton's anger. On learning, late on Saturday evening Oct 4, that the newspaper intended to publish a report, I attempted to persuade the duty night editor not to do so. As Horton stated, the Sunday Times reporter Lois Rogers telephoned a senior ICRF employee, who wrongly broke the embargo by answering some of her questions. Appropriate action is being taken with the individual concerned. Horton implies that someone at ICRF may have sent a copy of the paper to the Sunday Times. Our internal and external inquiries thus far indicate that the newspaper's source was in fact among the hundred or so authors outside ICRF. Much is made by Horton about Ardi Kolah's unsuccessful attempts to contact The Lancet. Kolah, head of ICRF's communications department, was simply making arrangements for the news conference to take place at the time of the paper's publication in The Lancet and wished to inform the journal of our plans. The further claim that ICRF's scientists are not allowed to represent their data in the public domain is rebutted by the authors' involvement in the news release and news conference as outlined earlier. The communications department was placed within the fundraising directorate because much of its day-today business is concerned with fundraising events and materials. Horton alleges that, with this move, ICRF is wilfully or inadvertently pursuing a policy of subordinating the presentation of scientific results to its fundraising message and profile. ICRF's fundraisers neither seek nor are given responsibility for the interpretation of scientific data. Moreover, what Horton fails to mention is that when dealing with the public presentation of our research the head of communications is and always has been directly responsible to me. The inaccuracies, the failure to check facts, and the intemperate language of Horton's Commentary are distressing. ICRF deserves an apology; The Lancet's readers deserve better from its editor. Imperial Cancer Research Fund and The LancetAuthors' reply Full-Text PDF