Sharh maqola

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

Mark LawlerCentre for Cancer Research and Cell Biology, Queen’s University Belfast, Belfast, UKDeborah AlsinaBowel Cancer UK, London, UKRichard AdamsSchool of Medicine, Cardiff University, Cardiff, UKAnnie S. AndersonResearch into Cancer Prevention and Screening, University of Dundee, Dundee, UKGina BrownDepartment of Radiology, Royal Marsden Hospital, Sutton, UKNicola FearnheadDepartment of Colorectal Surgery, Addenbrooke’s Hospital, Cambridge, UKStephen W. FenwickHepatobiliary Surgery Unit, Aintree University Hospital, Liverpool, UKStephen P HalloranFaculty of Health and Medical Sciences, University of Surrey, Guildford, UKDaniel HochhauserDepartment of Oncology, University College London Cancer Institute, London, UKMark A. HullLeeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UKViktor H. KoelzerMolecular and Population Genetics Laboratory, University of Oxford, Oxford, UKAngus McNairCentre for Surgical Research, University of Bristol, Bristol, UKKevin MonahanFamily History of Bowel Cancer Clinic, Imperial College London, London, UKInke NäthkeSchool of Life Sciences, University of Dundee, Dundee, UKChristine NortonFlorence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UKMarco NovelliResearch Department of Pathology, University College London Medical School, London, UKR. SteeleResearch into Cancer Prevention and Screening, University of Dundee, Dundee, UKAnne ThomasLeicester Cancer Research Centre, University of Leicester, Leicester, UKLisa WildeAtticus Consultants Ltd, Croydon, UKRichard H. WilsonCentre for Cancer Research and Cell Biology, Queen’s University Belfast, Belfast, UKIan TomlinsonInstitute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK

2017en

ABI

Annotatsiya

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.

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DOI: 10.1136/gutjnl-2017-315333

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