Critical Research Gaps and Recommendations to Inform Research Prioritisation for More Effective Prevention and Improved Outcomes in Colorectal Cancer

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

doi:10.1136/gutjnl-2017-315333

Critical Research Gaps and Recommendations to Inform Research Prioritisation for More Effective Prevention and Improved Outcomes in Colorectal Cancer

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

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Abstract

Objective: Colorectal cancer(CRC) leads to significant morbidity/mortality worldwide. Defining critical Research Gaps(RGs), 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 (WGs) were constituted: Discovery Science; Risk; Prevention; Early diagnosis and Screening; Pathology; Curative treatment; Stage IV disease; 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 (RRs) was endorsed by all participants.

Results: Fifteen Critical RGs are summarised below: RG1:Lack of realistic models that recapitulate tumour/tumour micro/macro-environment; 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.

Original language	English
Pages (from-to)	179-193
Number of pages	15
Journal	Gut
Volume	67
Issue number	1
Early online date	12 Dec 2017
DOIs	https://doi.org/10.1136/gutjnl-2017-315333
Publication status	Published - 1 Jan 2018

Keywords

colorectal cancer
critical research gaps
research prioritisation
funding
patient focus
Genetic Predisposition to Disease
Humans
Risk Factors
Biomedical Research/methods
Gene-Environment Interaction
Colorectal Neoplasms/diagnosis
Early Detection of Cancer/methods
Evidence-Based Medicine/methods

ASJC Scopus subject areas

Gastroenterology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/gutjnl-2017-315333Licence: CC BY-NC

Final Published VersionFinal published version, 745 KBLicence: CC BY-NC

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Lawler, M., Alsina, D., Adams, R., Anderson, A., Brown, G., Fearnhead, N. S., Fenwick, S. W., Halloran, S. P., Hochhauser, D., Hull, M. A., Koelzer, V. H., McNair, A. G. K., Monahan, K. J., Nathke, I., Norton, C., Novelli, M., Steele, R., Thomas, A. L., Wilde, L., ... Tomlinson, I. (2018). Critical Research Gaps and Recommendations to Inform Research Prioritisation for More Effective Prevention and Improved Outcomes in Colorectal Cancer. Gut, 67(1), 179-193. https://doi.org/10.1136/gutjnl-2017-315333

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title = "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(RGs), 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 (WGs) were constituted: Discovery Science; Risk; Prevention; Early diagnosis and Screening; Pathology; Curative treatment; Stage IV disease; 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 (RRs) was endorsed by all participants.Results: Fifteen Critical RGs are summarised below: RG1:Lack of realistic models that recapitulate tumour/tumour micro/macro-environment; 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.",

keywords = "colorectal cancer, critical research gaps, research prioritisation, funding, patient focus , Genetic Predisposition to Disease, Humans, Risk Factors, Biomedical Research/methods, Gene-Environment Interaction, Colorectal Neoplasms/diagnosis, Early Detection of Cancer/methods, Evidence-Based Medicine/methods",

author = "Mark Lawler and Deborah Alsina and Richard Adams and Annie Anderson and Gina Brown and Fearnhead, {Nicola S} and Fenwick, {Stephen W.} and Halloran, {Stephen P.} and Daniel Hochhauser and Hull, {Mark A.} and Koelzer, {Viktor H.} and McNair, {Angus G.K.} and Monahan, {Kevin J.} and Inke Nathke and Christine Norton and Marco Novelli and Robert Steele and Thomas, {Anne L.} and Lisa Wilde and Wilson, {Richard H.} and Ian Tomlinson",

note = "The BCUK Critical Research Gaps in Colorectal Cancer Initiative was financially supported by Bowel Cancer UK, The Norman Foster Foundation and the Tom Simms Memorial Fund at Queen's University Belfast. Working Group meetings and the BCUK-RG Evaluation Day were held at Bowel Cancer UK offices (140-148 Borough High St, London), NCVO (8 All Saints Street, London), Charles Russel Speechlys (5 Fleet Place, London) and Lewis PR (30 Millbanks, London); the latter two meeting spaces were provided pro bono. ",

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doi = "10.1136/gutjnl-2017-315333",

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Lawler, M, Alsina, D, Adams, R, Anderson, A, Brown, G, Fearnhead, NS, Fenwick, SW, Halloran, SP, Hochhauser, D, Hull, MA, Koelzer, VH, McNair, AGK, Monahan, KJ, Nathke, I, Norton, C, Novelli, M, Steele, R, Thomas, AL, Wilde, L, Wilson, RH & Tomlinson, I 2018, 'Critical Research Gaps and Recommendations to Inform Research Prioritisation for More Effective Prevention and Improved Outcomes in Colorectal Cancer', Gut, vol. 67, no. 1, pp. 179-193. https://doi.org/10.1136/gutjnl-2017-315333

TY - JOUR

T1 - Critical Research Gaps and Recommendations to Inform Research Prioritisation for More Effective Prevention and Improved Outcomes in Colorectal Cancer

AU - Lawler, Mark

AU - Alsina, Deborah

AU - Adams, Richard

AU - Anderson, Annie

AU - Brown, Gina

AU - Fearnhead, Nicola S

AU - Fenwick, Stephen W.

AU - Halloran, Stephen P.

AU - Hochhauser, Daniel

AU - Hull, Mark A.

AU - Koelzer, Viktor H.

AU - McNair, Angus G.K.

AU - Monahan, Kevin J.

AU - Nathke, Inke

AU - Norton, Christine

AU - Novelli, Marco

AU - Steele, Robert

AU - Thomas, Anne L.

AU - Wilde, Lisa

AU - Wilson, Richard H.

AU - Tomlinson, Ian

N1 - The BCUK Critical Research Gaps in Colorectal Cancer Initiative was financially supported by Bowel Cancer UK, The Norman Foster Foundation and the Tom Simms Memorial Fund at Queen's University Belfast. Working Group meetings and the BCUK-RG Evaluation Day were held at Bowel Cancer UK offices (140-148 Borough High St, London), NCVO (8 All Saints Street, London), Charles Russel Speechlys (5 Fleet Place, London) and Lewis PR (30 Millbanks, London); the latter two meeting spaces were provided pro bono.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: Colorectal cancer(CRC) leads to significant morbidity/mortality worldwide. Defining critical Research Gaps(RGs), 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 (WGs) were constituted: Discovery Science; Risk; Prevention; Early diagnosis and Screening; Pathology; Curative treatment; Stage IV disease; 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 (RRs) was endorsed by all participants.Results: Fifteen Critical RGs are summarised below: RG1:Lack of realistic models that recapitulate tumour/tumour micro/macro-environment; 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.

AB - Objective: Colorectal cancer(CRC) leads to significant morbidity/mortality worldwide. Defining critical Research Gaps(RGs), 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 (WGs) were constituted: Discovery Science; Risk; Prevention; Early diagnosis and Screening; Pathology; Curative treatment; Stage IV disease; 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 (RRs) was endorsed by all participants.Results: Fifteen Critical RGs are summarised below: RG1:Lack of realistic models that recapitulate tumour/tumour micro/macro-environment; 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.

KW - colorectal cancer

KW - critical research gaps

KW - research prioritisation

KW - funding

KW - patient focus

KW - Genetic Predisposition to Disease

KW - Humans

KW - Risk Factors

KW - Biomedical Research/methods

KW - Gene-Environment Interaction

KW - Colorectal Neoplasms/diagnosis

KW - Early Detection of Cancer/methods

KW - Evidence-Based Medicine/methods

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DO - 10.1136/gutjnl-2017-315333

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C2 - 29233930

SN - 0017-5749

VL - 67

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JO - Gut

JF - Gut

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ER -

Critical Research Gaps and Recommendations to Inform Research Prioritisation for More Effective Prevention and Improved Outcomes in Colorectal Cancer

Abstract

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UN SDGs

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Mechanisms of Intestinal Epithelial Responses to Inflammatory Modulators

Sonopill: Minimally Invasive Gastrointestinal Diagnosis and Therapy (Joint with University of Glasgow & Heriot Watt University)

Steele, Bob

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Critical Research Gaps and Recommendations to Inform Research Prioritisation for More Effective Prevention and Improved Outcomes in Colorectal Cancer

Abstract

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ASJC Scopus subject areas

UN SDGs

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Other files and links

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Mechanisms of Intestinal Epithelial Responses to Inflammatory Modulators

Sonopill: Minimally Invasive Gastrointestinal Diagnosis and Therapy (Joint with University of Glasgow & Heriot Watt University)

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Steele, Bob

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