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

Lawler, Mark, Alsina, Deborah, Adams, Richard A ORCID: https://orcid.org/0000-0003-3915-7243, 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 and Tomlinson, Ian 2018. Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer. Gut 67 (1) , pp. 179-193. 10.1136/gutjnl-2017-315333

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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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine Centre for Trials Research (CNTRR)
Publisher:	BMJ Publishing Group
ISSN:	0017-5749
Date of First Compliant Deposit:	25 May 2021
Date of Acceptance:	25 October 2017
Last Modified:	04 May 2023 14:30
URI:	https://orca.cardiff.ac.uk/id/eprint/141051

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