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National Institutes of Health: National Cancer Institute: Division of Cancer Control and Population Sciences
Grant Details

Grant Number: 5R01CA140574-03 Interpret this number
Primary Investigator: Hur, Chin
Organization: Massachusetts General Hospital
Project Title: Esophageal Adenocarcinoma Policy Model: Trends, Risk Factors and Screening
Fiscal Year: 2012
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Abstract

Project Summary/Abstract The incidence of esophageal adenocarcinoma (EAC) has been rising at an alarming rate over the past three decades. Although the absolute number of EAC cases per year remains too low to screen the general population, targeted screening may be appropriate. Heartburn, the primary symptom of gastroesophageal reflux disease (GERD), affects 60 million Americans and can lead to Barrett's esophagus (BE), a pre-malignant condition associated with the greatest risk (30-125x) of developing EAC. Because of the significant number of individuals affected with GERD and BE, the management of these patients has become a public health issue. However, an accepted screening or surveillance program for EAC has not been proposed. The broad, long-term objectives of the proposal are to identify an effective and affordable targeted screening strategy for EAC with early identification and an intervention program which will diminish the burden of this disease. These research goals will be accomplished developing and analyzing an Esophageal AdenoCarcinoma Policy Model (EACMo). A rich mix of complementary methodologies and state of the art simulation techniques will be necessary to achieve the numerous project objectives. Data from numerous sources including Surveillance Epidemiology and End Results (SEER), clinical trial data and the published literature will be used to develop a simulation model. Calibration methodology will be used to systematically fine tune model parameters to produce targeted endpoints (e.g. cancer incidence). Validation will be achieved by having the model reproduce other published data. The specific aims are: Aim 1: Develop and validate the EACMo Aim 2: Estimate contributions of pivotal risk factors to the rise in EAC incidence in the U.S. Aim 3: Identify individuals at high risk for EAC: predictors of Barrett's esophagus Aim 4: Estimate the effectiveness, cost and cost-effectiveness of plausible esophageal adenocarcinoma screening and management programs The health relatedness of the project will be to use the results to design clinical trials, guide policy decisions and inform evidence-based practice guidelines. The multidisciplinary research team assembled for this project has expertise in all aspects of simulation disease modeling, clinical aspects of EAC, and a proven history of research and collaborations.

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Publications

The Prevalence Of Barrett's Esophagus In The Us: Estimates From A Simulation Model Confirmed By Seer Data
Authors: Hayeck T.J. , Kong C.Y. , Spechler S.J. , Gazelle G.S. , Hur C. .
Source: Diseases Of The Esophagus : Official Journal Of The International Society For Diseases Of The Esophagus / I.s.d.e, 2010 Aug; 23(6), p. 451-7.
PMID: 20353441
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The Impact Of Obesity On The Rise In Esophageal Adenocarcinoma Incidence: Estimates From A Disease Simulation Model
Authors: Kong C.Y. , Nattinger K.J. , Hayeck T.J. , Omer Z.B. , Wang Y.C. , Spechler S.J. , McMahon P.M. , Gazelle G.S. , Hur C. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2011 Nov; 20(11), p. 2450-6.
PMID: 21930957
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Aspirin Protects Against Barrett's Esophagus In A Multivariate Logistic Regression Analysis
Authors: Omer Z.B. , Ananthakrishnan A.N. , Nattinger K.J. , Cole E.B. , Lin J.J. , Kong C.Y. , Hur C. .
Source: Clinical Gastroenterology And Hepatology : The Official Clinical Practice Journal Of The American Gastroenterological Association, 2012 Jul; 10(7), p. 722-7.
PMID: 22426086
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Screening And Surveillance For Barrett's Esophagus: Current Issues And Future Directions
Authors: Choi S.E. , Hur C. .
Source: Current Opinion In Gastroenterology, 2012 Jul; 28(4), p. 377-81.
PMID: 22508325
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The Cost Effectiveness Of Radiofrequency Ablation For Barrett's Esophagus
Authors: Hur C. , Choi S.E. , Rubenstein J.H. , Kong C.Y. , Nishioka N.S. , Provenzale D.T. , Inadomi J.M. .
Source: Gastroenterology, 2012 Sep; 143(3), p. 567-75.
PMID: 22626608
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Trends In Esophageal Adenocarcinoma Incidence And Mortality
Authors: Hur C. , Miller M. , Kong C.Y. , Dowling E.C. , Nattinger K.J. , Dunn M. , Feuer E.J. .
Source: Cancer, 2013-03-15 00:00:00.0; 119(6), p. 1149-58.
PMID: 23303625
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Statins And Aspirin For Chemoprevention In Barrett's Esophagus: Results Of A Cost-effectiveness Analysis
Authors: Choi S.E. , Perzan K.E. , Tramontano A.C. , Kong C.Y. , Hur C. .
Source: Cancer Prevention Research (philadelphia, Pa.), 2014 Mar; 7(3), p. 341-50.
PMID: 24380852
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Incidence And Predictors Of Adenocarcinoma Following Endoscopic Ablation Of Barrett's Esophagus
Authors: Yasuda K. , Choi S.E. , Nishioka N.S. , Rattner D.W. , Puricelli W.P. , Tramontano A.C. , Kitano S. , Hur C. .
Source: Digestive Diseases And Sciences, 2014 Jul; 59(7), p. 1560-6.
PMID: 24395382
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Preference Of Endoscopic Ablation Over Medical Prevention Of Esophageal Adenocarcinoma By Patients With Barrett's Esophagus
Authors: Yachimski P. , Wani S. , Givens T. , Howard E. , Higginbotham T. , Price A. , Berman K. , Hosford L. , Katcher P.M. , Ozanne E. , et al. .
Source: Clinical Gastroenterology And Hepatology : The Official Clinical Practice Journal Of The American Gastroenterological Association, 2015 Jan; 13(1), p. 84-90.
PMID: 24681073
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High-resolution Microendoscopy For Esophageal Cancer Screening In China: A Cost-effectiveness Analysis
Authors: Hur C. , Choi S.E. , Kong C.Y. , Wang G.Q. , Xu H. , Polydorides A.D. , Xue L.Y. , Perzan K.E. , Tramontano A.C. , Richards-Kortum R.R. , et al. .
Source: World Journal Of Gastroenterology, 2015-05-14 00:00:00.0; 21(18), p. 5513-23.
PMID: 25987774
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Early Pancreatic Ductal Adenocarcinoma Survival Is Dependent On Size: Positive Implications For Future Targeted Screening
Authors: Hur C. , Tramontano A.C. , Dowling E.C. , Brooks G.A. , Jeon A. , Brugge W.R. , Gazelle G.S. , Kong C.Y. , Pandharipande P.V. .
Source: Pancreas, 2015-12-18 00:00:00.0; , .
PMID: 26692444
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