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

Mark Lawler, Deborah Alsina, Richard A Adams, Annie S 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 Näthke, Christine Norton, Marco R Novelli, Robert J C Steele, Anne L Thomas, Lisa M Wilde, Richard H WilsonIan Tomlinson, Bowel Cancer UK Critical Research Gaps in Colorectal Cancer Initiative

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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.

Original languageEnglish
Pages (from-to)179-193
Number of pages15
JournalGut
Volume67
Issue number1
DOIs
Publication statusPublished - 01 Jan 2018

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Colorectal Neoplasms
Research
Communication
Pathology
Tumor Microenvironment
Triage
Ataxia
Genomics
Early Detection of Cancer
Uncertainty
Life Style
Early Diagnosis
Neoplasms
Therapeutics
Biomarkers
Quality of Life
Research Personnel
Technology
Morbidity
Mortality

Keywords

  • Journal Article
  • Review

Cite this

Lawler, M., Alsina, D., Adams, R. A., Anderson, A. S., Brown, G., Fearnhead, N. S., ... Bowel Cancer UK Critical Research Gaps in Colorectal Cancer Initiative (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
Lawler, Mark ; Alsina, Deborah ; Adams, Richard A ; 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 ; Tomlinson, Ian ; Bowel Cancer UK Critical Research Gaps in Colorectal Cancer Initiative. / Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer. In: Gut. 2018 ; Vol. 67, No. 1. pp. 179-193.
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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.",
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Lawler, M, Alsina, D, Adams, RA, Anderson, AS, Brown, G, Fearnhead, NS, Fenwick, SW, Halloran, SP, Hochhauser, D, Hull, MA, Koelzer, VH, McNair, AGK, Monahan, KJ, Näthke, I, Norton, C, Novelli, MR, Steele, RJC, Thomas, AL, Wilde, LM, Wilson, RH, Tomlinson, I & Bowel Cancer UK Critical Research Gaps in Colorectal Cancer Initiative 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

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; 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; Tomlinson, Ian; Bowel Cancer UK Critical Research Gaps in Colorectal Cancer Initiative.

In: Gut, Vol. 67, No. 1, 01.01.2018, p. 179-193.

Research output: Contribution to journalReview article

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 A

AU - Anderson, Annie S

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 - Näthke, Inke

AU - Norton, Christine

AU - Novelli, Marco R

AU - Steele, Robert J C

AU - Thomas, Anne L

AU - Wilde, Lisa M

AU - Wilson, Richard H

AU - Tomlinson, Ian

AU - Bowel Cancer UK Critical Research Gaps in Colorectal Cancer Initiative

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - Journal Article

KW - Review

U2 - 10.1136/gutjnl-2017-315333

DO - 10.1136/gutjnl-2017-315333

M3 - Review article

C2 - 29233930

VL - 67

SP - 179

EP - 193

JO - Gut

JF - Gut

SN - 0017-5749

IS - 1

ER -