Reducing the burden of colorectal cancer by optimising screening: evidence to clinical practice
Our Vision is to implement a personalised approach to screening to reduce the burden of colorectal cancer by optimising evidence-based screening and ensuring best use of health resources. We will do this by bringing together experts in clinical and non-clinical sciences: (a) to develop the first personalised colorectal cancer risk tool that incorporates all known genetic, pathology, family history, lifestyle factors and personal characteristics, and (b) to develop proven methods for implementing these tools in clinical practice.
People are not at equal risk of colorectal cancer (CRC). Risk is a composite of differences in exogenous factors and the not as well appreciated enormous variation in underlying familial, including genetic susceptibility. While genetic epidemiology and clinical research is increasing our knowledge of risk estimation and the capacity for prevention by screening, the incorporation of such knowledge into preventing CRC has been limited. As a result, we know that a substantial proportion of the population are being under-screened while many others are being over-screened, and colonoscopic screening is not being provided based on need. Screening for CRC in Australia is delivered via several mechanisms including the National Bowel Cancer Screening Program, general practitioners (GPs), gastroenterologists and family cancer clinics. However GPs do not have adequate CRC risk prediction tools to be able to always recommend the most appropriate screening method and interval to their patients. The population's disease burden from CRC could be efficiently reduced by improving determination of personal risk across the entire spectrum of disease so that those, and only those, at highest risk would be recommended to appropriately undertake colonoscopic screening. More appropriate and cost-effective colonoscopic screening can be provided to the Australian population. The most significant outcome that will arise from this Centre's work will be expanded evidence, tools and implementation strategies to support targeted risk-reducing screening for CRC in appropriate groups in the community.
Associate Professor Marie Pirotta (Department of General Practice, Melbourne Medical School, The University of Melbourne)
Professor John Emery (Department of General Practice, Melbourne Medical School, The University of Melbourne)
Professor Ingrid Winship (Melbourne Health)
Professor Finlay Macrae (Royal Melbourne Hospital Academic Centre, Melbourne Medical School, The University of Melbourne)
Professor Joanne Young (Brasil Hetzel Institute for Translational Health Research)
Associate Professor Alex Boussioutas (Peter Macallum Cancer Institute)
Professor Graham Giles (Cancer Council Victoria)
Professor James Bishop (Victorian Comprehensive Cancer Centre)
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