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Grant Details

Grant Number: 1R37CA222866-01 Interpret this number
Primary Investigator: Gupta, Samir
Organization: Veterans Medical Research Fdn/San Diego
Project Title: Post-Polypectomy Surveillance for Reducing Colon Cancer Incidence and Mortality
Fiscal Year: 2018
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Abstract

PROJECT SUMMARY Colorectal cancer (CRC) is the 2nd leading cause of cancer death in the United States. Research has consistently shown that screening reduces risks for CRC incidence and mortality. Effectiveness of screening has generally been attributed to detection and removal of precancerous polyps and curable cancers. In usual practice, routine follow up for many patients with polyps removed at baseline includes repeat surveillance colonoscopy to detect and resect additional polyps and cancer. However, the incremental benefit of surveillance colonoscopy over baseline colonoscopy with polyp removal is unclear. Indeed, prior research has not focused on effectiveness of surveillance and has not specifically determined whether a clinical strategy of systematic surveillance after baseline polypectomy reduces the risk of developing or dying from colorectal cancer, compared to no surveillance. Despite this gap in knowledge, current guidelines recommend routine surveillance colonoscopy for the majority of patients with polyps. Since colonoscopy is a burden on patients, associated with risks such as bleeding, and costly, it is imperative to establish whether surveillance reduces CRC risk. Our Specific Aims are to determine whether post polypectomy surveillance colonoscopy reduces CRC incidence (Aim 1) and mortality (Aim 2). To accomplish these aims, we will utilize a previously established cohort of over 400,000 individuals who had colonoscopy with polyp removal within the Department of Veterans Affairs (VA). Using a case-cohort design, all individuals with incident CRC identified by the VA Central Cancer Registry, all individuals with fatal CRC identified by the National Death Index, as well as a random sample of those who had polyps removed at baseline will be selected for study inclusion. We will use medical record review to determine exposure to surveillance colonoscopy and measure other factors that may influence CRC risk. Observed occurrence and timing of surveillance colonoscopy delivered will be summarized using a time- dependent exposure variable that characterizes adherence to post-polypectomy surveillance guidelines. CRC incidence, as well as CRC mortality will be compared among individuals exposed versus unexposed to surveillance colonoscopy, taking into account other factors that may influence CRC risk.

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Publications

Potential impact of family history-based screening guidelines on the detection of early-onset colorectal cancer.
Authors: Gupta S. , Bharti B. , Ahnen D.J. , Buchanan D.D. , Cheng I.C. , Cotterchio M. , Figueiredo J.C. , Gallinger S.J. , Haile R.W. , Jenkins M.A. , et al. .
Source: Cancer, 2020-07-01; 126(13), p. 3013-3020.
EPub date: 2020-04-20.
PMID: 32307706
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Racial and Ethnic Disparities in Colorectal Cancer Screening Pose Persistent Challenges to Health Equity.
Authors: Demb J. , Gupta S. .
Source: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2020 Jul; 18(8), p. 1691-1693.
EPub date: 2019-11-29.
PMID: 31786329
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Mailed fecal immunochemical test outreach for colorectal cancer screening: Summary of a Centers for Disease Control and Prevention-sponsored summit.
Authors: Gupta S. , Coronado G.D. , Argenbright K. , Brenner A.T. , Castañeda S.F. , Dominitz J.A. , Green B. , Issaka R.B. , Levin T.R. , Reuland D.S. , et al. .
Source: CA: a cancer journal for clinicians, 2020-06-25; , .
EPub date: 2020-06-25.
PMID: 32583884
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Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer.
Authors: Gupta S. , Lieberman D. , Anderson J.C. , Burke C.A. , Dominitz J.A. , Kaltenbach T. , Robertson D.J. , Shaukat A. , Syngal S. , Rex D.K. .
Source: Gastrointestinal endoscopy, 2020 03; 91(3), p. 463-485.e5.
EPub date: 2020-02-07.
PMID: 32044106
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Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer.
Authors: Gupta S. , Lieberman D. , Anderson J.C. , Burke C.A. , Dominitz J.A. , Kaltenbach T. , Robertson D.J. , Shaukat A. , Syngal S. , Rex D.K. .
Source: Gastroenterology, 2020 03; 158(4), p. 1131-1153.e5.
EPub date: 2020-02-07.
PMID: 32044092
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Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer.
Authors: Gupta S. , Lieberman D. , Anderson J.C. , Burke C.A. , Dominitz J.A. , Kaltenbach T. , Robertson D.J. , Shaukat A. , Syngal S. , Rex D.K. .
Source: The American journal of gastroenterology, 2020 03; 115(3), p. 415-434.
PMID: 32039982
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Lower Abnormal Fecal Immunochemical Test Cut-Off Values Improve Detection of Colorectal Cancer in System-Level Screens.
Authors: Berry E. , Miller S. , Koch M. , Balasubramanian B. , Argenbright K. , Gupta S. .
Source: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2020 Mar; 18(3), p. 647-653.
EPub date: 2019-05-11.
PMID: 31085338
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AGA Clinical Practice Guidelines on Management of Gastric Intestinal Metaplasia.
Authors: Gupta S. , Li D. , El Serag H.B. , Davitkov P. , Altayar O. , Sultan S. , Falck-Ytter Y. , Mustafa R.A. .
Source: Gastroenterology, 2020 02; 158(3), p. 693-702.
EPub date: 2019-12-06.
PMID: 31816298
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Risk Factors for Early-Onset Colorectal Cancer.
Authors: Low E.E. , Demb J. , Liu L. , Earles A. , Bustamante R. , Williams C.D. , Provenzale D. , Kaltenbach T. , Gawron A.J. , Martinez M.E. , et al. .
Source: Gastroenterology, 2020-01-09; , .
EPub date: 2020-01-09.
PMID: 31926997
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Peroral Endoscopic Myotomy versus Pneumatic Dilation in Achalasia: Dissecting the Randomized Controlled Trial.
Authors: Yadlapati R. , Gupta S. .
Source: Gastroenterology, 2020 01; 158(1), p. 276-277.
EPub date: 2019-11-05.
PMID: 31704302
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Causes of Socioeconomic Disparities in Colorectal Cancer and Intervention Framework and Strategies.
Authors: Carethers J.M. , Doubeni C.A. .
Source: Gastroenterology, 2020 01; 158(2), p. 354-367.
EPub date: 2019-11-01.
PMID: 31682851
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Does Colon Polyp Surveillance Improve Patient Outcomes?
Authors: Lieberman D. , Gupta S. .
Source: Gastroenterology, 2020 01; 158(2), p. 436-440.
EPub date: 2019-10-12.
PMID: 31614123
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Metformin Is Associated With Reduced Odds for Colorectal Cancer Among Persons With Diabetes.
Authors: Demb J. , Yaseyyedi A. , Liu L. , Bustamante R. , Earles A. , Ghosh P. , Gutkind J.S. , Gawron A.J. , Kaltenbach T.R. , Martinez M.E. , et al. .
Source: Clinical and translational gastroenterology, 2019 11; 10(11), p. e00092.
PMID: 31770138
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Ascertainment of Aspirin Exposure Using Structured and Unstructured Large-scale Electronic Health Record Data.
Authors: Bustamante R. , Earles A. , Murphy J.D. , Bryant A.K. , Patterson O.V. , Gawron A.J. , Kaltenbach T. , Whooley M.A. , Fisher D.A. , Saini S.D. , et al. .
Source: Medical care, 2019 10; 57(10), p. e60-e64.
PMID: 30807451
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Mailed Outreach Is Superior to Usual Care Alone for Colorectal Cancer Screening in the USA: A Systematic Review and Meta-analysis.
Authors: Jager M. , Demb J. , Asghar A. , Selby K. , Mello E.M. , Heskett K.M. , Lieberman A.J. , Geng Z. , Bharti B. , Singh S. , et al. .
Source: Digestive diseases and sciences, 2019 09; 64(9), p. 2489-2496.
EPub date: 2019-03-26.
PMID: 30915656
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Cost-Effectiveness and National Effects of Initiating Colorectal Cancer Screening for Average-Risk Persons at Age 45 Years Instead of 50 Years.
Authors: Ladabaum U. , Mannalithara A. , Meester R.G.S. , Gupta S. , Schoen R.E. .
Source: Gastroenterology, 2019 07; 157(1), p. 137-148.
EPub date: 2019-03-28.
PMID: 30930021
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Risk factors for colorectal cancer significantly vary by anatomic site.
Authors: Demb J. , Earles A. , Martínez M.E. , Bustamante R. , Bryant A.K. , Murphy J.D. , Liu L. , Gupta S. .
Source: BMJ open gastroenterology, 2019; 6(1), p. e000313.
EPub date: 2019-08-24.
PMID: 31523441
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Race/Ethnicity-, Socioeconomic Status-, and Anatomic Subsite-Specific Risks for Gastric Cancer.
Authors: Gupta S. , Tao L. , Murphy J.D. , Camargo M.C. , Oren E. , Valasek M.A. , Gomez S.L. , Martinez M.E. .
Source: Gastroenterology, 2019 01; 156(1), p. 59-62.e4.
EPub date: 2018-09-26.
PMID: 30267713
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