PO.PR01.01 · 预防研究
结直肠癌公平与影响（CLEAR-CRC）：结直肠癌联盟推进生物标志物检测的社区化模式
Colorectal cancer equity and impact (CLEAR-CRC): The colorectal cancer alliance's community-based model for advancing biomarker testing
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景：尽管综合性生物标志物检测在精准肿瘤学中的重要性日益增加，但仅约65%的结直肠癌（CRC）肿瘤接受了某种程度的分子检测。与城市患者相比，农村CRC患者接受推荐分子检测（如MSI）的可能性低20%。障碍包括提供者认知有限、后勤困难、经济限制以及提供者-患者沟通碎片化。结直肠癌联盟（Colorectal Cancer Alliance）召集了包括非营利组织、学术界、社区诊所和产业界在内的协作伙伴关系，启动了一项前瞻性研究，以提高这些服务不足人群中CRC患者对综合性生物标志物检测的采用率。
方法：该项目既设计为一项区域性健康传播活动，也是一项多模态质量改进工作。核心组成部分包括混合式患者导航、面向患者和医生的教育、改善生物标志物检测的可及性以及前瞻性纵向数据收集。该研究旨在从两个农村和一个城市临床站点招募100-120例晚期CRC患者。该研究利用联盟的BlueHQ数字支持平台支持知情同意、导航、患者和提供者教育以及纵向数据收集。健康传播活动将根据焦点小组的意见制定，并通过前后调查进行评估。纵向研究终点将包括生物标志物检测的知识、生物标志物检测的更新以及生物标志物驱动的护理提供。
结果：预计初步结果将在2026年初研究启动后发布。结局将通过患者报告的数据、导航记录以及对检测采用率和治疗决策的纵向追踪进行测量。研究启动前的关键里程碑包括完成信息传播材料、站点选择、导航员招募和培训以及IRB方案提交。
结论：本项目展示了一种可扩展、以公平为导向的方法，通过由使命驱动的患者倡导组织领导的协作性、多方利益相关者伙伴关系来改善CRC护理中生物标志物检测的可及性。本研究通过社区知情的信息传播、灵活的导航策略以及经由BlueHQ的集中化患者参与，采用以患者为中心的方法，以弥补CRC精准肿瘤学中持续存在的差距。我们综合质量改进干预措施的有效性将为未来减少差异的工作提供参考，并支持将综合性生物标志物检测推进为肿瘤学中的标准护理。
查看英文原文 English abstract
Background: Despite the growing importance of comprehensive biomarker testing in precision oncology, only approximately 65% of colorectal cancer (CRC) tumors undergo some level of molecular testing. Rural CRC patients are 20% less likely to receive recommended molecular testing (e.g. MSI) compared to urban patients. Barriers include limited provider awareness, logistical hurdles, financial constraints, and fragmented provider-patient communications. The Colorectal Cancer Alliance convened a collaborative partnership including non-profit, academia, community clinics and industry to launch a prospective study to increase the uptake of comprehensive biomarker tests among patients with CRC in these underserved populations.
Methods: The initiative is designed as both a regional health communication campaign and a multi-modal quality improvement effort. Core components include hybrid patient navigation, education for patients and physicians, improved access to biomarker testing, and prospective longitudinal data collection. The study aims to recruit 100-120 patients with advanced CRC from two rural and one urban clinical sites. The study leverages the Alliance's BlueHQ digital support platform to support consent, navigation, patient and provider education, and longitudinal data collection. The health communications campaign will be developed based on focus group input and evaluated by pre- and post-surveys. Longitudinal study endpoints will include knowledge of biomarker testing, updates on biomarker testing, and biomarker-driven care delivery.
Results: Preliminary results are expected to be released after the study launch in early 2026. Outcomes will be measured through patient-reported data, navigation logs, and longitudinal tracking of testing uptake and treatment decisions. Key milestones before study launch include completion of messaging materials, site selection, navigator recruitment and training, and IRB protocol submission.
Conclusions:This project models a scalable, equity-driven approach to improving access to biomarker testing in CRC care through collaborative, multi-stakeholder partnerships led by a mission-driven patient advocacy organization. This study adopts a patient-centric approach through community-informed messaging, flexible navigation strategies, and centralized patient engagement via BlueHQ to address persistent gaps in CRC precision oncology. The effectiveness of our comprehensive quality improvement intervention will inform future efforts to reduce disparities and support advancing comprehensive biomarker testing as a standard of care in oncology.
利益披露 Disclosure
K. L. Newcomer, None..
E. Siegel, None..
D. Fenstermacher, None..
M. Pearson, None..
L. Gladspell, None..
M. Mason, None.