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Controlling Esophageal Cancer: A Collaborative Modeling Approach

控制食管癌：协作建模方法

基本信息

批准号：
9753971
负责人：
Chin Hur
金额：
$ 116.31万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-01 至 2022-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9753971
关键词：
Address Adenocarcinoma Adenocarcinoma Cell American Area Asia Barrett Esophagus Biological Markers Biopsy Cancer Control Cancer Intervention and Surveillance Modeling Network Canes China Chinese People Clinical Data Decision Aid Diagnosis Dysplasia Endoscopy Esophageal Adenocarcinoma Esophageal Squamous Cell Carcinoma Evaluation Exercise Foundations Funding Gastroesophageal reflux disease Genomics Goals Guidelines Health Policy Healthcare Histologic Incidence Individual Intervention Knowledge Malignant Neoplasms Malignant neoplasm of esophagus Medical Methods Mission Modeling Morbidity - disease rate Natural History Outcome Output Patients Policies Population Premalignant Prevention Prevention strategy Public Health Publications Quality of life Research Research Project Grants Resources Risk Risk Factors Risk stratification Squamous cell carcinoma Structural Models Survival Rate Symptoms Technology United States National Institutes of Health Western World Work burden of illness clinical predictors comparative experience high risk improved men models and simulation mortality overtreatment patient screening preference prototype public health relevance screening surveillance strategy tool

项目摘要

DESCRIPTION (provided by applicant): Controlling Esophageal Cancer: A Collaborative Modeling Approach. The ultimate goal of the proposed research project is to advance our understanding of esophageal cancer and the impact of cancer control interventions to diminish the burden of this disease. This will be accomplished through a collaborative and comparative modeling project. There are two main histologic types of esophageal cancer: adenocarcinoma (EAC) and Squamous Cell Carcinoma (ESCC). Although ESCC is more common globally, in the US and much of the western world, EAC is more common and of greater concern. Esophageal AdenoCarcinoma (EAC) has experienced a remarkable (more than 6-fold) increase in incidence over the past few decades, which is largely unexplained. To date, primary screening and prevention efforts have targeted patients with symptoms of gastroesophageal reflux disease (GERD) using endoscopy and biopsy to identify patients with Barrett's esophagus (BE), with BE patients targeted for endoscopic surveillance. There is no firm evidence indicating that this screening/surveillance strategy is effective, which is underscored by persistently poor survival rates while a large proportion of cancers continue to be diagnosed at late and invasive stages. With an estimated 40-60 million Americans with GERD and 3-12 million with BE, the management of patients who are at significantly increased risk of EAC has become an important public health issue. In addition to uncertain long-term benefits, current unproven strategies may subject patients to overtesting and overdiagnosis, negatively impacting patient quality of life while expending considerable medical resources. The research team's prior work includes comparative modeling of the natural history of EAC by three independent models providing a strong foundation upon which to perform analyses that assess and improve screening and prevention strategies: specifically, the evaluation of cutting-edge enhancements such as new screening technologies, prevention, genomic and other biomarkers, and clinical prediction tools. Precision risk stratification is the aim, with the broader goal to identify a caner control strategy that is effective while limiting overtesting and overtreatment, thereby reducing patient burden and improving healthcare efficiency. These modeling efforts will provide the personalized patient data necessary to construct a decision aid, which will minimize patient screening burden by aligning management choices with personal preferences for screening. Finally, although the initial focus of the project will be on EAC, ESCC is more common and widespread globally, particularly in parts of Asia such as China. The models will be extended to include an ESCC natural history component and assess ESCC screening in the US and China. The proposal will address the overarching goals of increasing our understanding of the natural history of esophageal cancer and determining the impact and of potential cancer control interventions with the ultimate goal of ameliorating cancer morbidity.

描述（由申请人提供）：控制食管癌：协作建模方法。拟议研究项目的最终目标是促进我们对食管癌的理解，以及癌症控制干预措施对减轻这种疾病负担的影响。这将通过一个合作和比较建模项目来完成。食管癌有两种主要的组织学类型：腺癌（EAC）和鳞状细胞癌（ESCC）。虽然ESCC在全球范围内更为常见，但在美国和西方世界的大部分地区，EAC更为常见，也更受关注。食管腺癌（EAC）的发病率在过去几十年中显著增加（超过6倍），这在很大程度上无法解释。到目前为止，初级筛查和预防工作已经针对具有胃食管反流病（GERD）症状的患者，使用内窥镜检查和活检来识别Barrett食管（BE）患者，BE患者针对内窥镜监测。没有确凿的证据表明这种筛查/监测策略是有效的，这突出表现在存活率持续低下，而大部分癌症仍然在晚期和侵入性阶段被诊断出来。估计有4000 - 6000万美国人患有GERD，300 - 1200万患有BE，EAC风险显著增加的患者的管理已成为重要的公共卫生问题。除了不确定的长期效益外，目前未经证实的策略可能会使患者接受过度测试和过度诊断，对患者的生活质量产生负面影响，同时消耗大量的医疗资源。该研究小组的前期工作包括通过三个独立模型对EAC的自然史进行比较建模，为评估和改善筛查和预防策略提供了坚实的基础：具体而言，评估尖端增强技术，如新的筛查技术，预防，基因组和其他生物标志物以及临床预测工具。精确的风险分层是目标，更广泛的目标是确定一种有效的癌症控制策略，同时限制过度检测和过度治疗，从而减轻患者负担并提高医疗效率。这些建模工作将提供构建决策辅助所需的个性化患者数据，这将通过将管理选择与个人筛选偏好相结合来最大限度地减少患者筛选负担。最后，尽管该项目最初的重点是EAC，但ESCC在全球范围内更为常见和广泛，特别是在中国等亚洲部分地区。该模型将扩展到包括ESCC自然史成分，并评估美国和中国的ESCC筛查。该提案将解决增加我们对食管癌自然史的理解和确定潜在癌症控制干预措施的影响的总体目标，最终目标是改善癌症发病率。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Patients With Adenocarcinoma of the Esophagus or Esophagogastric Junction Frequently Have Potential Screening Opportunities.

DOI：
10.1053/j.gastro.2021.12.255
发表时间：
2022-04
期刊：
Gastroenterology
影响因子：
29.4
作者：
Rubenstein JH;Evans RR;Burns JA;Arasim ME;Zhu J;Waljee AK;Harnessing Opportunities to Screen for Esophageal Adenocarcinoma Group
通讯作者：
Harnessing Opportunities to Screen for Esophageal Adenocarcinoma Group

The Race-Specific Incidence of Esophageal Squamous Cell Carcinoma in Individuals With Exposure to Tobacco and Alcohol.

接触烟草和酒精的个体食管鳞状细胞癌的种族特异性发病率。

DOI：
10.1038/ajg.2016.346
发表时间：
2016
期刊：
The American journal of gastroenterology
影响因子：
0
作者：
Prabhu,Anoop;Obi,Kenneth;Lieberman,David;Rubenstein,JoelH
通讯作者：
Rubenstein,JoelH

The Impact of the Policy-Practice Gap on Costs and Benefits of Barrett's Esophagus Management.

DOI：
10.14309/ajg.0000000000000578
发表时间：
2020-07
期刊：
The American journal of gastroenterology
影响因子：
0
作者：
Omidvari AH;Roumans CAM;Naber SK;Kroep S;Wijnhoven BPL;Gaast AV;de Jonge PJ;Spaander MCW;Lansdorp-Vogelaar I
通讯作者：
Lansdorp-Vogelaar I

Estimates and predictors of health care costs of esophageal adenocarcinoma: a population-based cohort study.

食管腺癌的医疗保健成本的估计和预测因素：一项基于人群的队列研究。