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Patient-centered, risk-stratified surveillance after curative resection of colorectal cancer
Investigator (PI): Chang, George
Performing Organization (PO): (Current): Alliance for Clinical Trials in Oncology Foundation
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2014
Final Year: 2019
Record Source/Award ID: PCORI/CE-1304-6855
Funding: Total Award Amount: $1,826,664
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Number of Subjects: 180
Abstract: Nearly 14 million Americans are alive today having survived their battle with cancer. Colorectal cancer (CRC) is the second most common diagnosis among survivors, and the current population of 1.4 million colorectal cancer survivors is expected to grow nearly 25% by 2022. To these survivors, their family members and caregivers, as well as their physicians, the most pressing question is determining the best way to monitor the survivor in the future. Cancer surveillance has been identified as a top priority by organizations such as the Institute of Medicine and the Agency for Healthcare Research and Quality. Despite differences in patients' tumors and preferences the available colorectal cancer surveillance guidelines take mostly a one-size-fits-all approach. As a result, the quality of care, patient experience, and use of health care resources are compromised, and the research to generate evidence and tools to implement it are greatly needed. This proposal will address the critical question: Based on my individual tumor characteristics, conditions, and preferences, what is the best way to monitor for recurrence? We hypothesize that by tailoring the strategy for monitoring to the individual CRC survivor, their risk for recurrence, eligibility for salvage treatment, and personal preferences, the effectiveness of cancer monitoring would be improved and the burden on patients and the health care system would be alleviated. We specifically will 1) determine how effective CRC surveillance is and measure the risk and time to recurrence and death depending on different patients and tumors, through detailed analysis of surveillance data from colorectal cancer clinical trials conducted by the ALLIANCE network, as well as from the National Comprehensive Cancer Network (NCCN) and the National Cancer Database (NCDB); 2) identify key issues about CRC surveillance that are important to patients and clinicians, through stakeholder engagement within the ALLIANCE network as well as patients at the University of Texas MD Anderson Cancer Center; and 3) integrate the recurrence risk and patient priorities into a patient-centered, risk-stratified, surveillance strategy by creating an interactive decision aid that can be easily accessed by patients and clinicians. We will then design future studies to see the impact of this tailored surveillance strategy, including the benefits, harms, and changes in resource utilization when it is used in real-world situations. With a growing population of CRC survivors, the impact of cancer surveillance on patients and caregivers, physicians, and the health care system is great. The proposed research addresses an urgent and critical question these stakeholders face each day with little information to guide their decisions. The knowledge gained by this proposal will provide important new tools to guide patients and their clinicians in making individualized decisions regarding cancer surveillance.
MeSH Terms:
  • Caregivers
  • Colorectal Neoplasms /*surgery
  • Databases, Factual
  • Decision Making
  • Decision Support Techniques
  • Early Detection of Cancer /methods
  • Humans
  • Outcome Assessment (Health Care)
  • Patient Preference
  • Patient-Centered Care
  • Quality of Health Care
  • Recurrence
  • Risk
  • Survivors
  • Texas
  • Time Factors
  • United States
  • United States Agency for Healthcare Research and Quality
Country: United States
State: Illinois
Zip Code: 60606
UI: 20143529
CTgovId: NCT02217865
Project Status: Completed
Record History: ('2017: Project extended to 2018. Changed start and end dates, 3/10/2015.',) ('2018: Project extended to 2019.',)