1. Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer
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Mark Hull, Richard Houlston, Simon Bach, Inke Näthke, John Burn, Viktor Koelzer, Robert JC Steele, Annie Anderson, Vicky Goh, Jean-Baptiste Cazier, Kevin Monahan, Gina Brown, Daniel Hochhauser, Julian Downward, Anne Thomas, Richard Wilson, Angus McNair, Ultan McDermott, Leslie Samuel, Sam Ahmedzai, David Cunningham, Richard Adams, Marco Gerlinger, David Brewster, NIHR, University of Zurich, Lawler, Mark, and Saxton, John
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0301 basic medicine ,Biomedical Research ,Psychological intervention ,STAGE-II ,Review ,law.invention ,DOUBLE-BLIND ,0302 clinical medicine ,Randomized controlled trial ,QUALITY-OF-LIFE ,Risk Factors ,law ,Multidisciplinary approach ,1114 Paediatrics And Reproductive Medicine ,Early Detection of Cancer ,Evidence-Based Medicine ,Bowel Cancer UK Critical Research Gaps in Colorectal Cancer Initiative ,COLON-CANCER ,Gastroenterology ,Centre for Surgical Research ,030220 oncology & carcinogenesis ,CONSENSUS MOLECULAR SUBTYPES ,Colorectal Neoplasms ,Life Sciences & Biomedicine ,medicine.medical_specialty ,LONG-TERM ,610 Medicine & health ,colorectal cancer ,03 medical and health sciences ,Quality of life (healthcare) ,SDG 3 - Good Health and Well-being ,ANTERIOR RESECTION ,10049 Institute of Pathology and Molecular Pathology ,Recent Advances in Clinical Practice ,Journal Article ,medicine ,Humans ,2715 Gastroenterology ,Genetic Predisposition to Disease ,Intensive care medicine ,RECTAL-CANCER ,GASTROINTESTINAL SYMPTOMS ,Disease burden ,Science & Technology ,Gastroenterology & Hepatology ,business.industry ,1103 Clinical Sciences ,Evidence-based medicine ,A300 ,Triage ,PHYSICAL-ACTIVITY ,030104 developmental biology ,Gene-Environment Interaction ,business ,Working group - Abstract
ObjectiveColorectal cancer (CRC) leads to significant morbidity/mortality worldwide. Defining critical research gaps (RG), their prioritisation and resolution, could improve patient outcomes.DesignRG 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.ResultsFifteen 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.ConclusionPrioritising research activity and funding could have a significant impact on reducing CRC disease burden over the next 5 years.
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- 2017
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