Cancer Medicine (Jul 2023)

Development of cancer surveillance guidelines in ataxia telangiectasia: A Delphi‐based consensus survey of international experts

  • Renata Neves,
  • Blanca De Dios Perez,
  • Rafal Panek,
  • Sumit Jagani,
  • Sophie Wilne,
  • Jayesh M. Bhatt,
  • Caterina Caputi,
  • Emilia Cirillo,
  • David J. Coman,
  • Gregor Dückers,
  • Donald L. Gilbert,
  • Mary Kay Koenig,
  • Lobna Mansour,
  • Elizabeth McDermott,
  • Micaela Pauni,
  • Claudio Pignata,
  • Susan L. Perlman,
  • Oscar Porras,
  • Mariela Betina Porto,
  • Katherine Schon,
  • Pere Soler‐Palacin,
  • Sam Nick Russo,
  • Masatoshi Takagi,
  • Marc Tischkowitz,
  • Claire Wainwright,
  • Madhumita Dandapani,
  • Cristine Glazebrook,
  • Mohnish Suri,
  • William P. Whitehouse,
  • Robert A. Dineen

DOI
https://doi.org/10.1002/cam4.6075
Journal volume & issue
Vol. 12, no. 13
pp. 14663 – 14673

Abstract

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Abstract Background/Objectives Ataxia telangiectasia (A‐T) is a multiorgan disorder with increased vulnerability to cancer. Despite this increased cancer risk, there are no widely accepted guidelines for cancer surveillance in people affected by A‐T. We aimed to understand the current international practice regarding cancer surveillance in A‐T and agreed‐upon approaches to develop cancer surveillance in A‐T. Design/Methods We used a consensus development method, the e‐Delphi technique, comprising three rounds. Round 1 consisted of a Delphi questionnaire and a survey that collected the details of respondents' professional background, experience, and current practice of cancer surveillance in A‐T. Rounds 2 and 3 were designed based on previous rounds and modified according to the comments made by the panellists. The pre‐specified consensus threshold was ≥75% agreement. Results Thirty‐five expert panellists from 13 countries completed the study. The survey indicated that the current practice of cancer surveillance varies widely between experts and centres'. Consensus was reached that evidence‐based guidelines are needed for cancer surveillance in people with A‐T, with separate recommendations for adults and children. Statements relating to the tests that should be included, the age for starting and stopping cancer surveillance and the optimal surveillance interval were also agreed upon, although in some areas, the consensus was that further research is needed. Conclusion The international expert consensus statement confirms the need for evidence‐based cancer surveillance guidelines in A‐T, highlights key features that the guidelines should include, and identifies areas of uncertainty in the expert community. This elucidates current knowledge gaps and will inform the design of future clinical trials.

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