Top 10 research priorities for early-stage colorectal cancer: a Canadian patient-oriented priority-setting partnership

Colorectal cancer is one of the most commonly diagnosed cancers. We partnered with clinicians, patients and researchers from across Canada to determine the future research priorities for early-stage colorectal cancer. We followed a well-established process to partner with patients, as outlined by the James Lind Alliance. We surveyed patients, caregivers and clinicians to elicit their questions. We used this input to generate a list of potential research questions. We conducted a second survey to create a shorter list of highest-priority questions, which was reviewed at a final meeting. We used a consensus process to determine the top 10 priorities. The topic with greatest priority was prevention of recurrence of colorectal cancer. We encourage funding agencies and research teams to pursue the research questions generated through this collaborative national priority-setting process.

  1. What are the most effective ways to prevent recurrence?

  2. What additional policy, practice and educational initiatives are needed to improve screening rates, and how does this apply to screening for those who are under the age of 50?

  3. How can long-term changes to bowel function (including having an ostomy) be best managed, what is the role of rehabilitation in managing changes to bowel function, and are there new ways of managing this side effect that are being investigated?

  4. What is the role of personalized medicine, including immunotherapy, to tailor treatments based on patient and tumour characteristics? Would personalized medicine improve efficacy while decreasing side effects of CRC treatment?

  5. Are we able to find a test that is more sensitive or specific when used for screening for CRC?

  6. What is the cumulative financial toxicity of a CRC diagnosis, and how can patients and their families be better supported to manage this?

  7. How can patients be better informed about clinical trials and other research, and how can access to clinical trials and new treatments be improved?

  8. Can we predict who will get peripheral neuropathy (e.g., numbness and tingling in fingers and toes), and what is the best way to prevent peripheral neuropathy?

  9. What is the evidence for complementary and alternative medicine in a) the treatment of cancer and b) the prevention and/or management of short-term and long-term side effects from treatments?

  10. What is the best method to ensure that patients are fully informed and supported to make decisions during a) the diagnostic phase (e.g., diagnosis, prognosis, follow-up tests) and b) treatment phase? Are there any methods that can aid explanation and retention of information?

Cuthbert C, Nixon N, Vickers M, Samimi S, Rawson K, Ramjeesingh R, Karim S, Stein B, Laxdal G, Dundas L, Huband D, Daze E, Farrer C, Cheung WY. Top 10 research priorities for early-stage colorectal cancer: a Canadian patient-oriented priority-setting partnership. CMAJ Open. 2022 Mar 29;10(1):E278-E287. doi: 10.9778/cmajo.20210046. PMID: 35351780.

 

Peer Reviewed Journal Articles

 

  1. Grisbrook, MA, Dewey D., Cuthbert, C., McDonald S., Ntanda, H., Giesbrecht, G.F., Letourneau, N. Associations among Caesarean Section Birth, Post-Traumatic Stress, and Postpartum Depression. Submitted to International Journal of Environmental Research and Public Health. (accepted April 2022).
     

  2. Xu, Y., Cuthbert, C., Karim, S., Kong, S., Dort, J.C., Quan, M.L., Hinter, A.V., Quan, H., Hemmelgarn, B., & Cheung, B. (2022). Associations between physicians prescribing behaviors and persistent post-operative opioid use among cancer patients undergoing curative-intent surgery. Annals of Surgery. Feb 1;275(2):e473-e478. doi: 10.1097/SLA.0000000000003938.
     

  3. Cuthbert, CA, Nixon, N, Vickers, M, Samimi, S, Rawson, K, Ramjessingh, R.,Karim, S., Stein, B., Laxdal, G., Dundas, L., Huband, D. Daze, E., Farrer, C., Cheung, W. A patient oriented research approach to determine the top ten research priorities for early stage colorectal cancer. CMAJ open. (accepted Dec 2021).
     

  4. Lin N, Dabas E, Quan ML, Cheung WY, Cuthbert C, Feng Y, Kong S, Sauro K, Brenner D, Yang L, Xu Y. (2021). Outcomes and healthcare utilization among new persistent opioid users and non-opioid users after curative intent surgery for cancer. Annals of Surgery. doi:10.1097/SLA.0000000000005109
     

  5. Cuthbert C, Farragher JF, Farrer CL, Cheung WY. (2021). Living with paradox: A qualitative study of colorectal cancer patients and their caregivers’ experiences in managing health after cancer treatment. European Journal of Cancer Care, May 30(3), e13416. doi:10.1111/ecc.13416
     

  6. Batra, A, Yang, L., Boyne, D.J., Harper, A., Cuthbert, C., Cheung, W. (2020).  Symptom burden in patients with common cancers near end-of-life and its associations with clinical characteristics: A real world study. Support Care Cancer Jun;29(6):3299-3309. doi: 10.1007/s00520-020-05827-w. Epub 2020 Oct 26.
     

  7. Batra A, Yan L, Boyne D, Harper A, Cuthbert C, Cheung W. (2020). Association between baseline symptom burden as assessed by patient-reported outcomes and overall survival of patients with metastatic cancer. Supportive Care Cancer. Mar;29(3):1423-1431. doi: 10.1007/s00520-020-05623-6. Epub 2020 Jul 16.
     

  8. Singh N, Batra A, Yang L, Boyne D, Harper A, Ghatage P, Cuthbert C, Cheung W. (2020). Patient-reported outcomes near end-of-life in patients with gynaecological cancers. Journal of Obstetrics and Gynecology of Canada. Published July 2, 2020. Doi:10.1016/jogc.2020.06.017
     

  9.  Cuthbert, C., Boyne, D., Hemmelgarn, B., Cheung, W. (2020). Patient reported symptom burden and supportive care needs at cancer diagnosis: A retrospective cohort study. Supportive Cancer Cancer. Dec;28(12):5889-5899. doi: 10.1007/s00520-020-05415-y. Epub 2020 Apr 8.
     

  10. Cuthbert, C., Xu, Y, Kong, S., Boyne, D., Hemmelgarn, B., Cheung, W. (2020). Patient level factors associated with chronic opioid use in cancer: A population-based cohort study. Supportive Care Cancer, Sep;28(9):4201-4209. doi: 10.1007/s00520-019-05224-y. Epub 2020 Jan 3.  
     

  11. Cuthbert, C., Watson, L., Xu, Y., Boyne, D., Hemmelgarn, B.R., & Cheung, W. (2019). Collecting patient reported outcomes from cancer patients in Alberta: Rationale, scope, and design of a health services research database initiative. Current Oncology, 26(4), e503-e509. doi: https://doi.org/10.3747/co.26.4919
     

  12. Cuthbert, C.A, Farragher, J.F., Hemmelgarn, B.R., Qirui, D., McKinnon, G.P., Cheung, W. (2019). Self-management interventions for cancer survivors: A systematic review and evaluation of intervention content and theories. Psycho-Oncology. doi: 10.1002/pon.5215
     

  13. Boyne, D.J., Cuthbert, C.A., O’Sullivan, D.E., Sajobi, T.T., Hilsden, R.J., Friedenreich, C.E., Cheung, W.Y., Brenner, D.R. (2019). Adjuvant chemotherapy duration and survival among stage II and III colon cancer patients: A systematic review and meta-analysis. JAMA Netw Open, May 3;2(5):e194154 doi:10.1001/jamanetworkopen.2019.4154
     

  14. Cuthbert, C., Hemmelgarn, B.R., Yuan, X., Cheung, W. (2018) The effect of comorbidities on outcomes in colorectal cancer: a population based cohort study. Journal of Cancer Survivorship, 12, 733-743. doi: 10.1007/x11764-018-0719
     

  15. Cuthbert, C., Samawi, H., Hemmelgarn, B., Cheung, W. (2018). Effectiveness and Components of self-management interventions in adult cancer survivors: a protocol for a systematic review and planned meta-analysis. Systematic Reviews, 7,238. doi: 10.1186/s13643-018-0902-7
     

  16. Cuthbert, C., King-Shier, K., Ruether, D., Tapp, D., Wytsma-Fisher, W., Fung, T., & Culos-Reed, S.N. (2018). The effects of exercise on physical and psychological outcomes in cancer caregivers: Results from the RECHARGE randomized controlled trial. Annals of Behavioral Medicine, 52, 645-661. doi: 10.1093/abm/kax040.
     

  17. Cuthbert, C., King-Shier, K., Ruether,D., Culos-Reed, S.N., Bischoff, M.B., & Tapp, D. (2017) Creating an upward spiral: A qualitative study of caregivers’ experience of participating in a structured physical activity program. European Journal of Cancer Care. e12684. doi: 10.111/ecc.12684
     

  18. Cuthbert, C., King-Shier, K., Tapp, D., Ruether, D., & Culos-Reed, S.N. (2017) Exploring gender differences in self-reported physical activity levels and health among older caregivers. Oncology Nursing Forum, 44(4), 435-445. doi:10.1188/17.ONF.435-445
     

  19. Cuthbert, C., Culos-Reed, S.N., King-Shier, K., Ruether, D., & Tapp, D. (2017). What is the state of the science on exercise interventions for family caregivers: A systematic review and RE-AIM evaluation? Journal of Physical Activity and Health, 14, 587-596.  doi:10.1123/jpah.2016-0280
     

  20. Cuthbert, C., King-Shier, K., Tapp, D., Ruether, D., Jackson, C., & Culos-Reed, S.N. (2016). Renewing cancer caregiver health and wellbeing through exercise (RECHARGE): A randomized controlled trail. Contemporary Clinical Trials, 50, 274-283.
     

  21. Warr, J.K., Chambers, C., Cusano, F., Cuthbert, C., Mah, M. (2014). Feasibility of using the Multinational Association of Supportive Care in Cancer Antiemesis tool for assessment of chemotherapy induced nausea and vomiting at the Tom Baker Cancer Center. Journal of Oncology Pharmacy Practice. Published online.
     

  22. Cuthbert, C. and Moules, N. (2014). The application of qualitative research findings to oncology nursing practice. Oncology Nursing Forum, 41(6), 683-685. 

 

 

Letter to the Editor

1. Farrer, C., Daze, E., Born, K., Cuthbert, C. (2021). Adapting to a virtual format during COVID-19. CMAJ blogpost.

 

2. Cuthbert, C. (2019). Response to letter to the editor. Psycho-Oncology. doi:10.1002/pon.5319

 

Published Thesis

 

1. Cuthbert, C. (2017). The role of physical activity in supporting health and wellbeing in family caregivers to cancer patients. Electronic Theses. The University of Calgary. 419 pages.

 

 

Peer Reviewed Abstracts

* indicated published abstracts

 

  1. Howell D, Cuthbert C, Haase K, Lambert S. Are we there yet? The crucial role for self-management support to optimize health and well-being across the cancer care continuum. International Psychosocial Oncology Society/Canadian Association of Psychosocial Oncology World Congress. Aug 2022. Toronto, Canada. Symposium presentation.
     

  2. Cuthbert C, Wood T, Cheung W, Ruether D, Sinnarajah A, Tanguay R, Tarumi Y, Lau J. Exploring Provider Views of Prescribing Opioids to Early-Stage Cancer Patients in Alberta, Canada. Multinational Association of Supportive Care in Cancer. Annual conference June 2022 Toronto Canada. E-poster
     

  3. Harsanyi H, Cuthbert, C, Xu, Y, Yang, L, Cheung W, Lupichuk S, Quan ML, Harper A. Investigating Patterns of Opioid Use and its Association with Patient-Reported Outcomes among Patients with Metastatic Cancer Multinational Association of Supportive Care in Cancer. Annual conference June 2022 Toronto Canada. E-poster
     

  4. Harsanyi H, Cuthbert, C, Xu, Y, Yang, L, Cheung W, Lupichuk S, Quan ML, Harper A. Managing Cancer Pain: The Association between Opioid Use and Patient-Reported Pain in Metastatic Cancer Patients. Applied Research in Cancer Control annual virtual conference May 16-17, 2022. Oral presentation.
     

  5. Wagoner, CW, Dreger, J, Sibley, D, Chiekwe, J, Langley, J, Ester, M, Eisele, M, Santa Mina, D, Keats, MR, McNeely, ML, Cuthbert, C, Culos-Reed, SN. Virtual Implementation and Feasibility of EXCEL: Exercise for Underserved Individuals Living with Cancer (June 1, 2022). American College of Sports Medicine (ACSM) Annual Meeting. San Diego, California. In-Person Oral Presentation.
     

  6. Cuthbert, C., Cheung, W., Boyne, D., Brenner, D. The science of advancing evidence by reducing uncertainty: A multifaceted approach to real-world evidence (RWE) generation. Canadian Agency for Drugs & Technology in Health Annual Symposium. November 2021 (virtual). Panel presentation.
     

  7. Cuthbert C, Boyne D, O’Sullivan D, Cheung W. Use of patient reported outcomes to inform care of colorectal cancer patients in the post treatment period. Canadian Cancer Research Conference (virtual). Oct 2021. Poster presentation.
     

  8. Cuthbert C, Nixon N, Vickers M, Samimi S, Rawson K, Ramjessingh R, Karim S, Stein B, Laxdal  G, Dundas L, Huband D, Daze E, Farrer C, Cheung W. The top ten research priorities for early stage colorectal cancer: A Canadian patient oriented priority setting partnership. Canadian Cancer Research Conference (virtual). Oct 2021. Oral presentation.
     

  9. Culos-Reed SN, McNeely M, Santa Mina DS, Keats M, Cuthbert C, Dreger J, Sibley D, Chiekwe J, Langley J, Ester M, Sellars C, and the EXCEL project team. : Protocol for implementing a national exercise oncology program: Project EXCEL. Canadian Cancer Research Conference (virtual). Oct 2021. Poster presentation.
     

  10. Martens, R. Hunter-Smith, A., Hou, M., Isherwood, S., Quan, M.L., Cuthbert. C. Use and Impact of social media platforms for peer support by young adults living with cancer: A systematic review protocol. Alberta Cancer Research Conference (virtual). October 2021.
     

  11. Hunter-Smith, A., Cuthbert, C., Fergus, K., Barbera, L., Efegoma, Y., Howell, D., Isherwood, S., Levasseur, N., Scheer, A., Simmons, C., Srikantham A., Temple-Orberle, Xu, Y., Metcalfe, K., Quan, M.L. Preparing to survive: Improving outcomes for young women with breast cancer. Canadian Society of Surgical Oncology Annual Meeting May 2021. Winner, best oral presentation.
     

  12. Ddamba, J., Cheung, W., Dort, J., Cuthbert, C., Kong, S., Hinther, A. Prolonged opioid use in patients with head and neck cancer treated with surgery and post-operative radiotherapy. Aug 2020. Radiotherapy and Oncology 150:S91 doi:10.1016/s0167-8140(20)31107-5
     

  13. Batra, A., Cuthbert, C., Cheung, W. Burden of physical and psychological symptoms near end of life in patients with lung cancer using patient reported outcomes. Multinational Association of Supportive Cancer in Cancer Annual Conference. Seville, June 2020. Poster presentation. Deferred to June 2021 due to COVID-19
     

  14. Batra, A., Cuthbert, C., Rigo, R., Yang, L., Boyne, D., Harper, A., Cheung, W. Patient reported outcomes in patients with colorectal cancer near the end of life. Canadian Association of Medical Oncology Annual Conference. Toronto, Canada. May 2020. Poster presentation. Postponed due to COVID-19
     

  15. Batra, A., Cuthbert, C., Rigo, R., Yang, L. Boyne, D., Harper, A., Cheung, W. Patient reported outcomes near end of life in patients with breast cancer. European Society of Medical Oncology  Breast Cancer Annual Conference. Virtual meeting (due to COVID-19). May 23-24, 2020. Poster presentation.*
     

  16. Batra, A., Cuthbert, C., Rigo, R., Yang, L., Boyne, D., Harper, A., Cheung, W. Impact of baseline symptom burden as assessed by patient reported outcomes on overall survival of patients with metastatic gastric cancer. European Society of Medical Oncology World Gastrointestinal Cancer Conference. Virtual meeting (due to COVID-19). July, 2020. Poster presentation.*
     

  17. Batra, A., Cuthbert, C., Rigo, R., Yang, L., Boyne, D., Harper, A., Cheung, W. Patient reported outcomes in patients with gastric and esophageal cancers near end of life. European Society of Medical Oncology World Gastrointestinal Cancer Conference. Virtual meeting (due to COVID-19). July, 2020. Poster presentation.*
     

  18. Batra, A., Cuthbert, C., Rigo, R., Yang, L., Boyne, D., Harper, A., Cheung, W. Impact of baseline symptom burden as assessed by patient reported outcomes on overall survival of patients with metastatic cancer. American Society of Clinical Oncology Annual Conference. Virtual meeting (due to COVID-19). May, 2020. ASCO merit award winner. Poster presentation.*
     

  19. Cuthbert CA, Farragher JF,  Cheung WY.A Constant paradox : Colorectal cancers patients and family caregiver experience in managing health after cancer treatment. International Institute for Qualitative Methodology: Qualiative Health Research Methods Conference. Oral presentation. International Journal of Qualitative Methods, 19, 22. doi:10.1177/1609406920909934.*
     

  20. Cuthbert CA, Hemmelgarn BR,  Cheung WY.  Colorectal cancer patients and caregivers views on self management in the post treatment period : A qualitative study. International Institute for Qualitative Methodology: Qualitative Health Research Methods Conference. Poster presentation. International Journal of Qualitative Methods, 19, 62.  doi:10.1177/1609406920909934.*
     

  21. Cuthbert CA, Cheung WC, Nixon NA, Hemmelgarn BH, Rawson KA, Vickers M, Setareh S, Stein B, Laxdal G., Dundas L, Huband D. Determining the research priorities for those living with and beyond early stage colorectal cancer: Description of a research plan and early lessons learned. 5th Canadian Cancer Research Conference. Ottawa, ON. 2019. Poster presentation.
     

  22. Cuthbert, C., Xu, Y., Boyne, D., Kong, S., Hemmelgarn, B., Cheung, W. Factors associated with chronic opioid use in cancer patients. American Society of Clinical Oncology Annual 2019 Annual Meeting. Poster presentation. Journal of Clinical Oncology, 37, 15(Supp), 11580. Poster presentation. ASCO merit award winner.*
     

  23. Xu, Y., Cuthbert, C.A., Karim, S., Kong, S., Dort, J., Quan ML, Hinter, A., Cheung, W. Association of providers’ prescribing patterns with postsurgical opioid use among cancer patients undergoing curative-intent surgery. American Society of Clinical Oncology Annual 2019 Annual Meeting. Poster presentation. Journal of Clinical Oncology, 37, 15(Supp), 6530. Poster presentation. ASCO merit award winner.*
     

  24. Cuthbert, C., Hemmelgarn, B., Boyne, D., Cheung, W.Y. (2019). Developing precision supportive care in cancer using patient reported outcomes. Multinational Association of Supportive Cancer in Cancer Annual Conference, 2019. Eposter presentation. Supportive Care Cancer, 27 (Supp 1), S113.*
     

  25. Cuthbert, C. Hemmelgarn, B., Boyne, D., Cheung, W.Y. (2019). Using patient reported outcomes (PROs) to inform supportive care for geriatric oncology patients. Multinational Association of Supportive Cancer in Cancer Annual Conference, 2019. Eposter presentation Supportive Care Cancer, 27 (Supp 1), S119. *
     

  26. Cuthbert, C., Boyne, D., Hemmelgarn, B., Cheung, W. (2018). Using patient reported outcomes to hear the patient voice: Are we listening? American Society of Clinical Oncology Annual 2018 Annual Meeting. Journal of Clinical Oncology, 36(18_suppl, June 20, 2018)*
     

  27. Cuthbert, C., Hemmelgarn, B., Cheung, W. Effect of comorbidities on outcomes in colorectal cancer survivors. American Society of Clinical Oncology Annual 2018 Annual Meeting. Poster presentation. ASCO merit award winner. Journal of Clinical Oncology, 36(18_suppl, June 20, 2018)*
     

  28. Cuthbert, C., Tapp, D., King-Shier, K., Ruether, D., Wytsma-Fisher, K., Bischoff, M., & Culos-Reed, N. (2017). A mixed methods approach to understanding the impact of exercise in cancer family caregivers. Canadian Association of Psychosocial Oncology annual conference. Vancouver, BC. Podium presentation.
     

  29. Cuthbert, C., Tapp, D., King-Shier, K., Ruether, D., & Culos-Reed, N. (2017). Designing physical activity interventions based on family caregivers’ perspectives: Results from the RECHARGE trial. Society of Behavioral Medicine 38th annual meeting and scientific sessions, San Diego. Annals of Behavioral Medicine, 51, 1 suppl, March 2017.* Poster Presentation.
     

  30. Cuthbert, C., Culos-Reed, S.N., & Tapp, D. (Oct 2016). Taking action now to support family caregivers into the future: Ideas from research, practice and community models of care. Oral presentation at Canadian Association of Nurses in Oncology 28th annual national conference.
     

  31. Dowd, J., Cuthbert, C., & Culos-Reed, S.N. (Oct 2016). The role of self-compassion for nurses in clinical oncology. Oral presentation at Canadian Association of Oncology Nurses 28th annual national conference.
     

  32. Culos-Reed, S.N., Capozzi, L., Wytsma-Fisher, K., & Cuthbert, C. (Oct 2016) Physical activity for cancer survivors: Translation of the evidence into clinical oncology settings. Oral presentation at Canadian Association of Oncology Nurses 28th annual national conference.
     

  33. Cuthbert, C. King-Shier, K., Ruether, D., & Culos-Reed, S.N. (June 2016). Promoting health in older family caregivers: preliminary data in designing a physical activity intervention. Nominated by University of Calgary to present at Canadian Institutes of Health Research national student research poster competition, Winnipeg, MB.
     

  34. Cuthbert, C., Culos-Reed, S.N., King-Shier, K, Ruether, D., & Tapp, D. (Mar 2016). How active are older family caregivers to cancer patients? Motivations, barriers, and predictors of physical activity. Society of Behavioral Medicine annual meeting and scientific sessions. Annals of Behavioral Medicine; 50 (S1): S327*
     

  35. Cuthbert, C., Cook, D.J., & Culos-Reed, S.N. (Mar 2016). Recruitment in cancer settings, what helps, what hinders?: A qualitative study of health care providers’ views. Society of Behavioral Medicine annual meeting and scientific sessions. Annals of Behavioral Medicine; 50 (S1): S119*
     

  36. Cuthbert, C.,King-Shier, K., Ruether, J.D., Tapp, D. & Culos-Reed, S.N. (Jan 2016). Exploring correlates of quality of life in older family caregivers to cancer patients. Presented at American Society of Clinical Oncology 2016 Cancer Survivorship Symposium, San Francisco, CA, USA. J Clin Oncol 34, 2016 (suppl 3S; abstr 186)*
     

  37. Cuthbert,C, and Culos-Reed, S.N. (April 2015). Translating research on exercise interventions for caregivers: A review using the RE-AIM framework. Oral presentation at  Society of Behavioral Medicine 36th annual meeting and scientific sessions, April 23-25th, 2015, San Antonio, TX, USA. Annals of Behavioral Medicine; 49 (Suppl 1):S29.*
     

  38. Leach, H.J., Cuthbert, C., Danyluk, J,M., Culos-Reed, S.N. (April 2015). Correlates of breast cancer patients choosing to continue in an exercise maintenance program. Presented at Society of Behavioral Medicine 36th annual meeting and scientific sessions, April 23-25th, 2015, San Antonio, TX, USA. Annals of BehavioralMedicine; 49 (Suppl 1): S29.*