Dataset Information

Delphi Initiative for Early-Onset Colorectal Cancer (DIRECt) International Management Guidelines.

ABSTRACT:

Background & aims

Patients with early-onset colorectal cancer (eoCRC) are managed according to guidelines that are not age-specific. A multidisciplinary international group (DIRECt), composed of 69 experts, was convened to develop the first evidence-based consensus recommendations for eoCRC.

Methods

After reviewing the published literature, a Delphi methodology was used to draft and respond to clinically relevant questions. Each statement underwent 3 rounds of voting and reached a consensus level of agreement of ≥80%.

Results

The DIRECt group produced 31 statements in 7 areas of interest: diagnosis, risk factors, genetics, pathology-oncology, endoscopy, therapy, and supportive care. There was strong consensus that all individuals younger than 50 should undergo CRC risk stratification and prompt symptom assessment. All newly diagnosed eoCRC patients should receive germline genetic testing, ideally before surgery. On the basis of current evidence, endoscopic, surgical, and oncologic treatment of eoCRC should not differ from later-onset CRC, except for individuals with pathogenic or likely pathogenic germline variants. The evidence on chemotherapy is not sufficient to recommend changes to established therapeutic protocols. Fertility preservation and sexual health are important to address in eoCRC survivors. The DIRECt group highlighted areas with knowledge gaps that should be prioritized in future research efforts, including age at first screening for the general population, use of fecal immunochemical tests, chemotherapy, endoscopic therapy, and post-treatment surveillance for eoCRC patients.

Conclusions

The DIRECt group produced the first consensus recommendations on eoCRC. All statements should be considered together with the accompanying comments and literature reviews. We highlighted areas where research should be prioritized. These guidelines represent a useful tool for clinicians caring for patients with eoCRC.

SUBMITTER: Cavestro GM

PROVIDER: S-EPMC11207185 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Delphi Initiative for Early-Onset Colorectal Cancer (DIRECt) International Management Guidelines.

Cavestro Giulia Martina GM Mannucci Alessandro A Balaguer Francesc F Hampel Heather H Kupfer Sonia S SS Repici Alessandro A Sartore-Bianchi Andrea A Seppälä Toni T TT Valentini Vincenzo V Boland Clement Richard CR Brand Randall E RE Buffart Tineke E TE Burke Carol A CA Caccialanza Riccardo R Cannizzaro Renato R Cascinu Stefano S Cercek Andrea A Crosbie Emma J EJ Danese Silvio S Dekker Evelien E Daca-Alvarez Maria M Deni Francesco F Dominguez-Valentin Mev M Eng Cathy C Goel Ajay A Guillem Josè G JG Houwen Britt B S L BBSL Kahi Charles C Kalady Matthew F MF Kastrinos Fay F Kühn Florian F Laghi Luigi L Latchford Andrew A Liska David D Lynch Patrick P Malesci Alberto A Mauri Gianluca G Meldolesi Elisa E Møller Pål P Monahan Kevin J KJ Möslein Gabriela G Murphy Caitlin C CC Nass Karlijn K Ng Kimmie K Oliani Cristina C Papaleo Enrico E Patel Swati G SG Puzzono Marta M Remo Andrea A Ricciardiello Luigi L Ripamonti Carla Ida CI Siena Salvatore S Singh Satish K SK Stadler Zsofia K ZK Stanich Peter P PP Syngal Sapna S Turi Stefano S Urso Emanuele Damiano ED Valle Laura L Vanni Valeria Stella VS Vilar Eduardo E Vitellaro Marco M You Yi-Qian Nancy YN Yurgelun Matthew B MB Zuppardo Raffaella Alessia RA Stoffel Elena M EM

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 20221220 3

<h4>Background & aims</h4>Patients with early-onset colorectal cancer (eoCRC) are managed according to guidelines that are not age-specific. A multidisciplinary international group (DIRECt), composed of 69 experts, was convened to develop the first evidence-based consensus recommendations for eoCRC.<h4>Methods</h4>After reviewing the published literature, a Delphi methodology was used to draft and respond to clinically relevant questions. Each statement underwent 3 rounds of voting and reached a ...[more]

PMID: 36549470

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Dataset Information

Delphi Initiative for Early-Onset Colorectal Cancer (DIRECt) International Management Guidelines.

Background & aims

Methods

Results

Conclusions

Publications

Delphi Initiative for Early-Onset Colorectal Cancer (DIRECt) International Management Guidelines.

Similar Datasets

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