Lawler, M. et al. (2017) 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. (doi: 10.1136/gutjnl-2017-315333) (PMID:29233930) (PMCID:PMC5754857)
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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: | Articles |
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Additional Information: | The study was funded by Bowel Cancer UK, the Norman Foster Foundation and the Tom Simms Memorial Fund at Queen’s University Belfast. |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Wilson, Professor Richard |
Authors: | Lawler, M., Alsina, D., Adams, R. A., Anderson, A. S., 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., Näthke, I., Norton, C., Novelli, M. R., Steele, R. J.C., Thomas, A. L., Wilde, L. M., Wilson, R. H., and Tomlinson, I. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cancer Sciences |
Journal Name: | Gut |
Publisher: | BMJ Publishing Group |
ISSN: | 0017-5749 |
ISSN (Online): | 1468-3288 |
Copyright Holders: | Copyright © 2018 The Authors |
First Published: | First published in Gut 67(1):179-193 |
Publisher Policy: | Reproduced under a Creative Commons License |
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