Development of good practice statements (GPSs) for the prevention of colorectal cancer

Article type
Authors
Alonso P1, Jimenez E2, Lopez-Alcalde J3, Matteos M4, Rigau D1, Stallings E5, Zamora J6
1Iberoamerican Cochrane Centre - Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBERESP, Barcelona, Spain
2Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain; Clinical Biostatistics Unit, Hospital universitario Ramón y Cajal, IRYCIS, Cochrane Madrid, Madrid, Spain
3Clinical Biostatistics Unit, Hospital universitario Ramón y Cajal, Cochrane Madrid, IRYCIS, CIBERESP, Madrid, Spain; Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
4Clinical Biostatistics Unit, Hospital universitario Ramón y Cajal, IRYCIS, Cochrane Madrid, Madrid, Spain
5Clinical Biostatistics Unit, Hospital universitario Ramón y Cajal, Cochrane Madrid, IRYCIS, CIBERESP, Madrid, Spain
6Clinical Biostatistics Unit, Hospital universitario Ramón y Cajal, Cochrane Madrid, IRYCIS, CIBERESP, Madrid, Spain; Institute of Metabolism and Systems Research, WHO Collaborating Centre for Global Women's Health, University of Birmingham, Birmingham, United Kingdom
Abstract
Background
Good practice statements (GPSs) are actionable statements deemed necessary for practice (desirable effects of an intervention clearly outweigh its undesirable effects) and are supported by indirect evidence that does not diminish the certainty in evidence.
Objective
As part of the European Commission Initiative on Colorectal Cancer (ECICC), this study aimed to develop 4 GPSs related to colorectal cancer prevention, focusing on reducing alcohol consumption, quitting smoking, practicing physical activity, and counselling for healthy lifestyles.
Methods
Before developing the GPSs, the following questions were addressed: 1) Is the statement clear and actionable? 2) Is the message necessary in regard to actual health care practice? 3) After consideration of all relevant outcomes, will implementing the GPSs result in large net positive consequences? 4) Is collecting and summarizing the evidence a poor use of a guideline panel’s limited time? 5) Is there a well-documented clear and explicit rationale connecting the indirect evidence? The answers to all questions were "yes," and we could proceed with the development of the GPSs.
We searched for indirect evidence to identify key documentation supporting the judgements made by the guideline development group (GDG). To inform these GPSs, we provided a narrative and tabulated summary of the objectives, key results, and conclusions of identified systematic reviews. We also assessed the risk of bias in identified systematic reviews using the ROBIS tool.
Results
Pragmatic literature searches identified reports from international institutions (eg, International Agency for Research on Cancer, World Health Organization), the Global Burden of Disease study, and up-to-date recommendations from international guidelines.
The ECICC GDG read and approved the information and evidence to support the conclusions of these GPSs for individuals at average risk of colorectal cancer.
Conclusion
The ECICC recommends reducing alcohol consumption, quitting smoking, maintaining regular physical activity, and counselling on healthy lifestyles for all individuals (ungraded good practice statement).
The development of clear GPS for colorectal cancer prevention on reducing alcohol consumption, quitting smoking, engaging in regular physical activity, and counselling for healthy lifestyles ensures the receipt of actionable and reliable guidance.