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A Personalized Approach to Targeted Esophageal Cancer Screening

针对性食管癌筛查的个性化方法

基本信息

批准号：
10212990
负责人：
Chin Hur
金额：
$ 50.67万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-08 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10212990
关键词：
Award Biopsy Cancer Control Case Fatality Rates Cells Characteristics Clinical Research Collaborations Colorectal Cancer Cost Analysis Data Devices Effectiveness Endoscopy Esophageal Adenocarcinoma Esophagus Financial cost Foundations Funding Future Goals Health system Healthcare Systems Histologic Incidence Individual Life Expectancy Logistics Malignant Neoplasms Malignant neoplasm of esophagus Mass Screening Methods Modality Modeling Morbidity - disease rate Natural History Patients Performance Population Prevention Primary Health Care Procedures Provider Regimen Research Research Personnel Research Project Grants Risk Sampling Screening for cancer Technology Testing Western World Work base burden of illness cost cost effective cost effectiveness cost estimate experience high risk improved individual patient innovation insight member models and simulation mortality new technology novel novel strategies personalized approach personalized screening primary care setting profiles in patients screening screening program

项目摘要

The goal of the project is to diminish the morbidity and mortality associated with esophageal cancer as patients with this cancer continue to suffer from extremely poor survival and high case-fatality rates. Esophageal adenocarcinoma (EAC) is the most common histologic type of esophageal malignancy in the US and has experienced an alarmingly rapid and largely unexplained rise in incidence over the past four decades in much of the western world. Previous attempts to curb the morbidity and mortality associated with EAC in the US have focused on an endoscopic screening, which is invasive and costly. However, innovative new technologies for esophageal cancer screening that are both less invasive and costly have created the opportunity to lower the bar for screening to where it could be a realistic option, particularly for those who are higher risk. While the performance metrics of the device are important, equally critical are identifying and resolving barriers to implementation. We propose to study potential factors for patients, providers and health care systems that could impede screening programs. This R01 proposal will leverage a previously developed and validated natural history simulation model of EAC. The PI has made significant contributions to the fields of esophageal cancer screening, prevention and treatment utilizing the EAC model to assess and analyze critical aspects of EAC cancer control. The prior work and model will provide an exceptionally strong foundation for the current research project. The research team is comprised of experienced investigators who provide the broad and complementary expertise necessary for this project and have a track record of successful collaboration. The overarching premise of our proposal is that novel approaches to esophageal cancer screening have the potential to improve EAC mortality, but that the successful implementation and population impact will depend on: 1) the screening modality characteristics; 2) patient, provider, and health system’s barriers; and 3) the profile of the patients to be screened. We will accomplish these project goals by completing four specific aims. In Aim 1 we will use our validated simulation model of esophageal cancer to test and assess whether a cell sampling device can be cost-effective for population screening. In Aim 2 we will study potential patient, provider and health system barriers to esophageal cancer screening. For Aim 3 we will personalize screening by determining which patient profiles will benefit from screening. Finally, in Aim 4 will assess the population cancer control impact of the potential implementation of the esophageal cancer screening strategy defined by the prior aims. By award period end, we will have developed a personalized approach to targeted EAC screening that is rational and cost-effective.

该项目的目标是降低食管癌患者的发病率和死亡率