Details

Autor(en) / Beteiligte

• Lawler, Mark
• Alsina, Deborah
• Adams, Richard A
• Anderson, Annie S
• Brown, Gina
• Fearnhead, Nicola S
• Fenwick, Stephen W
• Halloran, Stephen P
• Hochhauser, Daniel
• Hull, Mark A
• Koelzer, Viktor H
• McNair, Angus G K
• Monahan, Kevin J
• Näthke, Inke
• Norton, Christine
• Novelli, Marco R
• Steele, Robert J C
• Thomas, Anne L
• Wilde, Lisa M
• Wilson, Richard H
• Tomlinson, Ian

Titel

Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer

Ist Teil von

• Gut, 2018-01, Vol.67 (1), p.179-193

Ort / Verlag

England: BMJ Publishing Group LTD

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• ObjectiveColorectal cancer (CRC) leads to significant morbidity/mortality worldwide. Defining critical research gaps (RG), their prioritisation and resolution, could improve patient outcomes.DesignRG analysis was conducted by a multidisciplinary panel of patients, clinicians and researchers (n=71). Eight working groups (WG) were constituted: discovery science; risk; prevention; early diagnosis and screening; pathology; curative treatment; stage IV disease; and living with and beyond CRC. A series of discussions led to development of draft papers by each WG, which were evaluated by a 20-strong patient panel. A final list of RGs and research recommendations (RR) was endorsed by all participants.ResultsFifteen critical RGs are summarised below: RG1: Lack of realistic models that recapitulate tumour/tumour micro/macroenvironment; RG2: Insufficient evidence on precise contributions of genetic/environmental/lifestyle factors to CRC risk; RG3: Pressing need for prevention trials; RG4: Lack of integration of different prevention approaches; RG5: Lack of optimal strategies for CRC screening; RG6: Lack of effective triage systems for invasive investigations; RG7: Imprecise pathological assessment of CRC; RG8: Lack of qualified personnel in genomics, data sciences and digital pathology; RG9: Inadequate assessment/communication of risk, benefit and uncertainty of treatment choices; RG10: Need for novel technologies/interventions to improve curative outcomes; RG11: Lack of approaches that recognise molecular interplay between metastasising tumours and their microenvironment; RG12: Lack of reliable biomarkers to guide stage IV treatment; RG13: Need to increase understanding of health related quality of life (HRQOL) and promote residual symptom resolution; RG14: Lack of coordination of CRC research/funding; RG15: Lack of effective communication between relevant stakeholders.ConclusionPrioritising research activity and funding could have a significant impact on reducing CRC disease burden over the next 5 years.