Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer
作者:Mark Lawler,1 Deborah Alsina,2 Richard A Adams,3 Annie S Anderson,4 Gina Brown,5 Nicola S Fearnhead,6 Stephen W Fenwick,7 Stephen P Halloran,8 Daniel Hochhauser,9 Mark A Hull,10 Viktor H Koelzer,11 Angus G K McNair,12 Kevin J Monahan,13 Inke Näthke,14 Christine Norton,15 Marco R Novelli,16 Robert J C Steele,4 Anne L Thomas,17 Lisa M Wilde,2,18 Richard H Wilson,1 Ian Tomlinson,19 on behalf of the Bowel Cancer UK Critical Research Gaps in Colorectal Cancer Initiative
摘要: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.
关键词:effective prevention, improved outcome,colorectal cancer
论文方向:[{"id":896,"name":"医药科学"},{"id":899,"name":"消化系统"}]
发表期刊:
数字识别码:10.1136/gutjnl-2017-315333
是否作者本人: 否
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