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Grant Details

Grant Number: 5R01CA140574-04 Interpret this number
Primary Investigator: Hur, Chin
Organization: Massachusetts General Hospital
Project Title: Esophageal Adenocarcinoma Policy Model: Trends, Risk Factors and Screening
Fiscal Year: 2013
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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

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 PM, Ozanne E, Perzan K, Hur C
Source: Clin Gastroenterol Hepatol, 2015 Jan;13(1), p. 84-90.
EPub date: 2014 Mar 26.
PMID: 24681073
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Incidence and predictors of adenocarcinoma following endoscopic ablation of Barrett's esophagus.
Authors: Yasuda K, Choi SE, Nishioka NS, Rattner DW, Puricelli WP, Tramontano AC, Kitano S, Hur C
Source: Dig Dis Sci, 2014 Jul;59(7), p. 1560-6.
EPub date: 2014 Jan 7.
PMID: 24395382
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Statins and aspirin for chemoprevention in Barrett's esophagus: results of a cost-effectiveness analysis.
Authors: Choi SE, Perzan KE, Tramontano AC, Kong CY, Hur C
Source: Cancer Prev Res (Phila), 2014 Mar;7(3), p. 341-50.
EPub date: 2013 Dec 31.
PMID: 24380852
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Trends in esophageal adenocarcinoma incidence and mortality.
Authors: Hur C, Miller M, Kong CY, Dowling EC, Nattinger KJ, Dunn M, Feuer EJ
Source: Cancer, 2013 Mar 15;119(6), p. 1149-58.
EPub date: 2012 Dec 11.
PMID: 23303625
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The cost effectiveness of radiofrequency ablation for Barrett's esophagus.
Authors: Hur C, Choi SE, Rubenstein JH, Kong CY, Nishioka NS, Provenzale DT, Inadomi JM
Source: Gastroenterology, 2012 Sep;143(3), p. 567-75.
EPub date: 2012 May 21.
PMID: 22626608
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Screening and surveillance for Barrett's esophagus: current issues and future directions.
Authors: Choi SE, Hur C
Source: Curr Opin Gastroenterol, 2012 Jul;28(4), p. 377-81.
PMID: 22508325
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Aspirin protects against Barrett's esophagus in a multivariate logistic regression analysis.
Authors: Omer ZB, Ananthakrishnan AN, Nattinger KJ, Cole EB, Lin JJ, Kong CY, Hur C
Source: Clin Gastroenterol Hepatol, 2012 Jul;10(7), p. 722-7.
EPub date: 2012 Mar 15.
PMID: 22426086
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The impact of obesity on the rise in esophageal adenocarcinoma incidence: estimates from a disease simulation model.
Authors: Kong CY, Nattinger KJ, Hayeck TJ, Omer ZB, Wang YC, Spechler SJ, McMahon PM, Gazelle GS, Hur C
Source: Cancer Epidemiol Biomarkers Prev, 2011 Nov;20(11), p. 2450-6.
EPub date: 2011 Sep 19.
PMID: 21930957
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The prevalence of Barrett's esophagus in the US: estimates from a simulation model confirmed by SEER data.
Authors: Hayeck TJ, Kong CY, Spechler SJ, Gazelle GS, Hur C
Source: Dis Esophagus, 2010 Aug;23(6), p. 451-7.
EPub date: 2010 Mar 26.
PMID: 20353441
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