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This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made ; BACKGROUND: Several prognostic signatures for early oestrogen receptor-positive (ER+) breast cancer have been established with a 10-year follow-up. We tested the hypothesis that signatures optimised for 0-5-year and 5-10-year follow-up separately are more prognostic than a single signature optimised for 10 years. METHODS: Genes previously identified as prognostic or associated with endocrine resistance were tested in publicly available microarray data set using Cox regression of 747 ER+/HER2- samples from post-menopausal patients treated with 5 years of endocrine therapy. RNA expression of the selected genes was assayed in primary ER+/HER2- tumours from 948 post-menopausal patients treated with 5 years of anastrozole or tamoxifen in the TransATAC cohort. Prognostic signatures for 0-10, 0-5 and 5-10 years were derived using a penalised Cox regression (elastic net). Signature comparison was performed with likelihood ratio statistics. Validation was done by a case-control (POLAR) study in 422 samples derived from a cohort of 1449. RESULTS: Ninety-three genes were selected by the modelling of microarray data; 63 of these were significantly prognostic in TransATAC, most similarly across each time period. Contrary to our hypothesis, the derived early and late signatures were not significantly more prognostic than the 18-gene 10-year signature. The 18-gene 10-year signature was internally validated in the TransATAC validation set, showing prognostic information similar to that of Oncotype DX Recurrence Score, PAM50 risk of recurrence score, Breast Cancer Index and IHC4 (score based on four IHC markers), as well as in the external POLAR case-control set. CONCLUSIONS: The derived 10-year signature predicts risk of metastasis in patients with ER+/HER2- breast cancer similar to commercial signatures. The hypothesis that early and late prognostic signatures are significantly more informative than a single signature was rejected. ; This work was supported by Breast Cancer Now working in partnership with Walk the Walk, as well as by the National Institute for Health Research Royal Marsden/ICR Biomedical Research Centre. ARB was funded by Cancer Research UK (grant number C569/A16891). The study was supported by funds from Skåne County Council's Research and Development Foundation, Governmental Funding of Clinical Research within the National Health Service (grant number ALFSKANE-350191 [to MK]), the Swedish Breast Cancer Association (BRO), the Mrs Berta Kamprad Foundation and The Inger Persson Research Foundation. IS and JC were supported by Cancer Research UK (programme grant C569/A10404).

Breast Cancer Now. Grant Number: 2015MayPR515 ; National Institute for Health Research. Grant Numbers: IS‐BRC‐1215‐20007, NF‐SI‐0513‐10076 ; Prevent Breast Cancer. Grant Numbers: GA09‐002, GA11‐002 ; Cancer Research UK. Grant Numbers: C1287/A10118, C1287/A16563, C569/A16891 ; National Institutes of Health. Grant Numbers: X01HG007492, U19 CA148065 ; Canadian Institutes of Health Research. Grant Number: GPH‐129344 ; Horizon 2020 Research and Innovation Programme. Grant Numbers: 634935, 633784 ; European Union. Grant Number: HEALTH‐F2‐2009‐223175

Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010.They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines.