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Biomarkers for optimizing risk prediction and early detection of cancers of the colon and esophagus

用于优化结肠癌和食道癌风险预测和早期检测的生物标志物

基本信息

批准号：
10677825
负责人：
William Mallory Grady
金额：
$ 100.92万
依托单位：
FRED HUTCHINSON CANCER CENTER
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-05 至 2027-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10677825
关键词：
Affect Age Age Years Barrett Esophagus Biological Assay Biological Markers CLIA certified Cancer Etiology Cancer Prevention Trial Cessation of life Chronic Clinical Collaborations Colon Colonoscopy Colorectal Cancer Cytology Development Devices Dysplasia Early Detection Research Network Early Diagnosis Economics Effectiveness Eligibility Determination Endoscopy Esophageal Adenocarcinoma Esophageal Precancerous Condition Esophagus Familial Adenomatous Polyposis Syndrome Family history of Gastroesophageal reflux disease Goals Healthcare Healthcare Systems Hereditary Neoplastic Syndromes Hereditary Nonpolyposis Colorectal Neoplasms High grade dysplasia Histologic Incidence Individual Lesion Malignant Neoplasms Malignant neoplasm of esophagus Malignant neoplasm of gastrointestinal tract Methods Modeling Morbidity - disease rate Patients Persons Phase Population Prevention Prevention program Program Efficiency Progress Reports Recommendation Recording of previous events Resources Risk Risk Factors Risk Marker Sampling Screening for cancer Serrated Adenoma Stress Surveillance Program Survival Rate System Testing Treatment Cost Tubular Adenoma United States National Institutes of Health adenoma clinic ready colon cancer patients colon cancer screening colorectal cancer prevention colorectal cancer risk colorectal cancer screening colorectal cancer treatment cost cost effective detection assay early detection biomarkers effectiveness evaluation esophageal cancer prevention financial toxicity high risk high risk population improved mortality premalignant prevent preventable death progression risk risk prediction risk stratification screening screening program social standard of care success trend virtual

项目摘要

Project Summary Gastrointestinal (GI) cancers are a major cause of mortality and morbidity in the U.S. and their treatment uses a substantial proportion of healthcare resources. Of the GI cancers, colorectal cancer (CRC) and esophageal cancer (EAC) account for a majority of the cancer related deaths, and both are preventable by screening and surveillance. The current screening tests are suboptimal and have variable success. A major goal of CRC screening tests is to identify advanced tubular and serrated adenomas, which are high-risk for becoming CRC, as well as early stage CRC. The risk for CRC is variable with some people being at high risk because of family histories of CRC, hereditary cancer syndromes, or a personal history of adenomas. High risk people are placed on aggressive colonoscopy based surveillance programs and low-risk people are placed on minimal surveillance programs. Unfortunately, our current system for identifying high and low CRC risk is suboptimal resulting in under and over surveillance and preventable interval CRCs. Better risk markers for CRC to are needed to prevent interval CRCs and improve the overall effectiveness of CRC screening. Analogous to CRC, EAC arises from a precancerous condition of the esophagus called Barretts esophagus (BE), which is a specialized intestinal metaplasia of the esophagus and the highest risk factor for EAC. It is present in 5% of the US population. BE progresses to EAC through successive histologic steps of low grade dysplasia (LGD), high grade dysplasia (HGD) and then EAC. Screening and surveillance for BE is recommended using serial upper endoscopy, which is controversial in its effectiveness for preventing deaths from EAC. This is in part because, as with CRC, BE patients have variable risk of EAC and are placed on high- risk and low-risk screening programs. However, the current system for assigning risk is not accurate and the current screening test is expensive. More cost effective and accurate EAC and HGD screening/surveillance assays and accurate BE risk biomarkers are needed. We propose to develop an EDRN BCC that is integrated into the EDRN consortium and, through collaborations within and outside the EDRN, will develop effective GI cancer screening biomarkers. We propose to identify, validate, and develop accurate CLIA compliant risk biomarkers for CRC and for EAC in order to prevent EAC and CRC missed under current screening protocols. Moreover, the accurate risk stratification of patients for CRC and EAC will reduce the financial impact of current CRC and EAC prevention programs. We also propose to identify and validate accurate CLIA compliant early detection markers for HGD and early stage EAC that can be used in an inexpensive, non-endoscopic surveillance test.

项目总结