The Epidemiology of Barrett's Esophagus in Children

描述（由申请人提供）： 巴雷特食管（BE）是食管腺癌的唯一已知的前驱病变，这是美国白人男性中增长最快的癌症。BE的发病年龄不详。BE是由慢性胃食管反流病（GERD）引起的，已知该疾病在儿童时期发展。因此，儿童GERD可能是BE的危险因素。拟议研究的目标是使用多中心网络项目（称为儿科内窥镜数据库系统-临床结局研究计划（PEDS-CORI））中收集的回顾性和前瞻性数据，检查儿童和青少年BE的流行病学。具体目的是：（1）确定接受上消化道内镜检查的儿童和青少年中根据内镜和组织学标准定义的BE患病率;（2）评价接受内镜检查的儿童和青少年中根据统一内镜和组织学标准定义的BE的人口统计学特征（年龄、性别、种族）和临床决定因素（合并症、GERD症状）。这些目标将通过两项旨在获得BE患病率估计值的横断面研究实现：使用1999年至2004年期间从所有PEDS-CORI站点收集的信息进行的回顾性研究（预计16，000例手术），随后在三个PEDS-CORI研究中心进行为期一年的前瞻性内窥镜研究（预计1，800例手术），其中将收集更多BE特定信息。这项前瞻性研究包括严格标准化的观察和记录内镜和组织学结果，以及有关潜在危险因素的具体问题。本研究的长期目标是为一项前瞻性多中心研究奠定可行性和样本量的基础，该研究涉及所有PEDS-CORI研究中心，将检查儿童和青少年BE的风险因素。

DESCRIPTION (provided by applicant): Barrett's Esophagus (BE) is the only known precursor lesion for esophageal adenocarcinoma, which is the fastest rising cancer in Caucasian men in the United States. The age of onset of BE is unknown. BE results from chronic gastroesophageal reflux disease (GERD), which is known to develop during childhood. Hence, childhood GERD could be a risk factor for BE. The goal of the proposed research is to examine the epidemiology of BE in children and adolescents using retrospective as well as prospective data collected in the multicenter network project known as Pediatric Endoscopy Database System-Clinical Outcomes Research Initiative (PEDS-CORI). The Specific Aims are (1) to determine the prevalence of BE as defined by endoscopic and histologic criteria in children and adolescents undergoing upper endoscopy; and (2) to evaluate the demographic features (age, gender, ethnicity) and clinical determinants (comorbidity, GERD symptoms) of BE as defined by uniform endoscopic and histologic criteria among children and adolescents undergoing endoscopy. These aims will be achieved through two cross-sectional studies designed to obtain estimates of the prevalence of BE: a retrospective study using information collected from all PEDS-CORI sites between 1999 and 2004 (an expected 16,000 procedures), followed by a one-year prospective endoscopic study in three PEDS-CORI sites (an expected 1,800 procedures), in which additional BE-specific information will be collected. The prospective study includes rigorous standardization of the observation and recording of endoscopic and histologic findings and specific questions about potential risk factors. The long-term objectives of this research are to lay the groundwork in terms of feasibility and sample size for a prospective multicenter study involving all PEDS-CORI sites that will examine the risk factors for BE in children and adolescents.