Background Uptake of cancer trials and in particular prevention trials has been disappointing globally.

Methods Uptake to three randomised chemotherapy breast cancer prevention trials and two dietary prevention trials in women at increased familial risk were assessed and compared with uptake of screening trials across a range of risk categories.

Results Uptake of drug prevention trials remains low at 5.3–13.6%, but is significantly higher in the high (12%) compared to very high risk group (8.4%) for IBIS1 and IBIS2 combined (p=0.004). Recruitment to two dietary prevention studies via mail shot was also disappointingly low at 6.2% and 12.5%. In contrast uptake to two mammography screening trials was >90% in all risk categories.

Conclusions More work must be done to improve recruitment to prevention trials if they are to be seen as viable alternatives to risk reducing surgery.

Impact Trial designs and decision aids need to be developed to improve recruitment.