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

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

UR - https://www.scopus.com/pages/publications/85038370196

U2 - 10.1136/gutjnl-2017-315333

DO - 10.1136/gutjnl-2017-315333

M3 - Article

C2 - 29233930

SN - 0017-5749

VL - 67

SP - 179

EP - 193

JO - Gut

JF - Gut

IS - 1

ER -