TY - JOUR T1 - Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer JF - Gut JO - Gut SP - 179 LP - 193 DO - 10.1136/gutjnl-2017-315333 VL - 67 IS - 1 AU - Mark Lawler AU - Deborah Alsina AU - Richard A Adams AU - Annie S Anderson AU - Gina Brown AU - Nicola S Fearnhead AU - Stephen W Fenwick AU - Stephen P Halloran AU - Daniel Hochhauser AU - Mark A Hull AU - Viktor H Koelzer AU - Angus G K McNair AU - Kevin J Monahan AU - Inke Näthke AU - Christine Norton AU - Marco R Novelli AU - Robert J C Steele AU - Anne L Thomas AU - Lisa M Wilde AU - Richard H Wilson AU - Ian Tomlinson A2 - , Y1 - 2018/01/01 UR - http://gut.bmj.com/content/67/1/179.abstract 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. ER -