Professor El-Omar has selected Dr Christopher M Jones from the Department of Oncology, University of Cambridge and Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK to do the next #GUTBlog.  Dr Jones is the first author on this paper.

The #GUTBlog focusses on the paper entitled “Research priorities for cancers of the oesophagus and stomach: recommendations from a UK and Ireland patient and healthcare professional partnership exercise” which was published in paper copy in GUT in December 2025.

Dr Jones writes in the #GUTBlog:

“What should research into oesophageal and gastric cancers focus on?

Perhaps you might think that we know the answer. That researchers should focus on what we believe to be the most promising treatments or the areas that we recognise to be the most problematic from our own clinical practice or lived experience of these cancers. Yet we know that we do not have the resources to enable this. There is not sufficient funding for us to undertake every study we might consider worthwhile for people facing these diagnoses, not least given that upper gastrointestinal cancers receive just 1.5% of global public and philanthropic research funding. There are also too few scientists and clinicians to deliver very large numbers of studies, which in any case would require more patients than have an oesophageal or gastric cancer diagnosis.  As importantly, we also know in other cancer settings that the areas healthcare professionals and the pharmaceutical industry choose to focus on often poorly align with those that patients consider important.

We had these points in mind when some years ago we – the Oesophagogastric Research Groups of the UK National Cancer Research Institute and its successor, the UK & Ireland Oesophagogastric Research Group – tried to find evidence to help us prioritise research studies. However, we found little to guide us to do so in the literature. There were a few well-intentioned consensus processes that provided viewpoints from a small number of specialties involved in the care of patients with oesophageal and gastric cancer but none included a patient voice.

We resolved to change this and soon brought together a study leadership group that comprised five patients, three scientists and 32 healthcare professionals from across each discipline involved in the care of patients with an oesophageal or gastric cancer. Together, we resolved to address the need to identify areas of research priority for oesophageal and gastric cancer and to do so through close partnership between patients and healthcare professionals from community and hospital settings. We also decided to be ambitious and to consider research priorities across domains encompassing the disease spectrum; from prevention and diagnosis/staging to non-surgical and surgical treatment, through to palliative care and survivorship. This ambition was well received and we were delighted to go on to receive backing and endorsement from 19 healthcare professional organisations and 12 patient groups.

This endorsement was crucial to our success in the first phase of this work. During this, we used social media, in-person presentations and offline articles to patient groups as well as emails sent out via a large number of mailing lists to ask patients and healthcare professionals to tell us their research priorities. In total, 455 people replied to our surveys. Remarkably, approaching 200 of these respondents were patients, whilst the healthcare professionals represented 25 different professional groups. Between them, they raised a tremendous 4295 suggestions. We manually reviewed these and found that they grouped to effectively ask 92 research questions. Each of these was systematically appraised and found to represent a true research uncertainty.

The challenge then was that it was not clear whether patients and healthcare professionals would agree on which of these questions should be prioritised; either overall or within specific domains such as palliative care or survivorship. In pilot work it also proved difficult for patients and healthcare professionals to prioritise all 92 complex research questions. To address this, we adapted a method from the Child Health & Nutrition Research Initiative (CHNRI). This allowed us to first ask patients what their priorities were for each domain (i.e. prevention, diagnosis & staging, treatment, survivorship, palliative care). These priorities were chosen from a list of four possible research objectives (broadly defined as scientific interest, equitable benefit, living longer, living with better of quality of life) chosen by the study leadership group. We then applied these as weightings to healthcare professionals’ rankings of each research question, allowing us to build a final list of overall and domain-specific research priorities. Importantly, between 22.2-46.3% of the healthcare professional priorities were altered when weighted by patient priorities for what the research was to achieve.

The final priority lists are shown in our recent publication. Some are not unexpected. There is, for example, a strong emphasis on patient selection for therapy and on identifying effective treatment combinations. Others are less obvious, including strong prioritisation of nutritional support and addressing the translational gap for surgical innovations. Together, the top 20 research priorities and the domain-specific priorities we have identified provide a valuable framework to which patients and a variety of healthcare professionals have contributed, and that will guide future research activity and funding across prevention through to survivorship and palliative care. None of this would have been possible without the time and dedication of the patients and healthcare professionals who helped to run this study and who responded to our questionnaires. We are grateful to all of them.”

Learn more by accessing the paper here: https://gut.bmj.com/content/74/12/1949.