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

Abstract：

OBJECTIVE:Colorectal cancer (CRC) leads to significant morbidity/mortality worldwide. Defining critical research gaps (RG), their prioritisation and resolution, could improve patient outcomes. DESIGN:RG 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. RESULTS:Fifteen 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. CONCLUSION:Prioritising research activity and funding could have a significant impact on reducing CRC disease burden over the next 5 years.

journal_name

Gut

journal_title

Gut

authors

Lawler M,Alsina D,Adams RA,Anderson AS,Brown G,Fearnhead NS,Fenwick SW,Halloran SP,Hochhauser D,Hull MA,Koelzer VH,McNair AGK,Monahan KJ,Näthke I,Norton C,Novelli MR,Steele RJC,Thomas AL,Wilde LM,Wilson RH,Tomlins

doi

10.1136/gutjnl-2017-315333

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

179-193

issue

eissn

0017-5749

issn

1468-3288

pii

gutjnl-2017-315333

journal_volume

pub_type

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