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Grant Details

Grant Number: 5U01CA199336-05 Interpret this number
Primary Investigator: Hur, Chin
Organization: Columbia University Health Sciences
Project Title: Controlling Esophageal Cancer: a Collaborative Modeling Approach
Fiscal Year: 2019
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Abstract

 DESCRIPTION (provided by applicant): Controlling Esophageal Cancer: A Collaborative Modeling Approach. The ultimate goal of the proposed research project is to advance our understanding of esophageal cancer and the impact of cancer control interventions to diminish the burden of this disease. This will be accomplished through a collaborative and comparative modeling project. There are two main histologic types of esophageal cancer: adenocarcinoma (EAC) and Squamous Cell Carcinoma (ESCC). Although ESCC is more common globally, in the US and much of the western world, EAC is more common and of greater concern. Esophageal AdenoCarcinoma (EAC) has experienced a remarkable (more than 6-fold) increase in incidence over the past few decades, which is largely unexplained. To date, primary screening and prevention efforts have targeted patients with symptoms of gastroesophageal reflux disease (GERD) using endoscopy and biopsy to identify patients with Barrett's esophagus (BE), with BE patients targeted for endoscopic surveillance. There is no firm evidence indicating that this screening/surveillance strategy is effective, which is underscored by persistently poor survival rates while a large proportion of cancers continue to be diagnosed at late and invasive stages. With an estimated 40-60 million Americans with GERD and 3-12 million with BE, the management of patients who are at significantly increased risk of EAC has become an important public health issue. In addition to uncertain long-term benefits, current unproven strategies may subject patients to overtesting and overdiagnosis, negatively impacting patient quality of life while expending considerable medical resources. The research team's prior work includes comparative modeling of the natural history of EAC by three independent models providing a strong foundation upon which to perform analyses that assess and improve screening and prevention strategies: specifically, the evaluation of cutting-edge enhancements such as new screening technologies, prevention, genomic and other biomarkers, and clinical prediction tools. Precision risk stratification is the aim, with the broader goal to identify a caner control strategy that is effective while limiting overtesting and overtreatment, thereby reducing patient burden and improving healthcare efficiency. These modeling efforts will provide the personalized patient data necessary to construct a decision aid, which will minimize patient screening burden by aligning management choices with personal preferences for screening. Finally, although the initial focus of the project will be on EAC, ESCC is more common and widespread globally, particularly in parts of Asia such as China. The models will be extended to include an ESCC natural history component and assess ESCC screening in the US and China. The proposal will address the overarching goals of increasing our understanding of the natural history of esophageal cancer and determining the impact and of potential cancer control interventions with the ultimate goal of ameliorating cancer morbidity.

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Publications

Diabetes in relation to Barrett's esophagus and adenocarcinomas of the esophagus: A pooled study from the International Barrett's and Esophageal Adenocarcinoma Consortium.
Authors: Petrick J.L. , Li N. , Anderson L.A. , Bernstein L. , Corley D.A. , El Serag H.B. , Hardikar S. , Liao L.M. , Liu G. , Murray L.J. , et al. .
Source: Cancer, 2019-09-06; , .
EPub date: 2019-09-06.
PMID: 31490550
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Esophageal cancer treatment costs by phase of care and treatment modality, 2000-2013.
Authors: Tramontano A.C. , Chen Y. , Watson T.R. , Eckel A. , Hur C. , Kong C.Y. .
Source: Cancer medicine, 2019 Sep; 8(11), p. 5158-5172.
EPub date: 2019-07-26.
PMID: 31347306
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Interactive decision support for esophageal adenocarcinoma screening and surveillance.
Authors: Vaughan T.L. , Onstad L. , Dai J.Y. .
Source: BMC gastroenterology, 2019-06-27; 19(1), p. 109.
EPub date: 2019-06-27.
PMID: 31248371
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Low Prevalence of Suspected Barrett's Esophagus in Patients With Gastroesophageal Reflux Disease Without Alarm Symptoms.
Authors: Lin E.C. , Holub J. , Lieberman D. , Hur C. .
Source: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2019 Apr; 17(5), p. 857-863.
EPub date: 2018-09-07.
PMID: 30196157
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Lorenz Curves and Gini Coefficient Analyses Indicate Inefficiencies in Esophageal Adenocarcinoma Screening.
Authors: Hur C. , Zhan T. , Thrift A.P. , Vaughan T.L. , Feuer E.J. .
Source: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2019 Feb; 17(3), p. 560-562.e2.
EPub date: 2018-05-09.
PMID: 29753084
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Hospice use and end-of-life care among older patients with esophageal cancer.
Authors: Tramontano A.C. , Nipp R. , Kong C.Y. , Yerramilli D. , Gainor J.F. , Hur C. .
Source: Health science reports, 2018 Sep; 1(9), p. e76.
EPub date: 2018-07-19.
PMID: 30623099
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Outcome of endoscopic mucosal resection in Barrett's esophagus determined by systematic quantification of epithelial glands using volumetric laser endomicroscopy.
Authors: Kamboj A.K. , Kahn A. , Sawas T. , Lutzke L.S. , Iyer P.G. , Wang K.K. , Leggett C.L. .
Source: Gastrointestinal endoscopy, 2019 04; 89(4), p. 701-708.e1.
EPub date: 2018-10-16.
PMID: 30339951
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Implications of Epigenetic Drift in Colorectal Neoplasia.
Authors: Luebeck G.E. , Hazelton W.D. , Curtius K. , Maden S.K. , Yu M. , Carter K.T. , Burke W. , Lampe P.D. , Li C.I. , Ulrich C.M. , et al. .
Source: Cancer research, 2019-02-01; 79(3), p. 495-504.
EPub date: 2018-10-05.
PMID: 30291105
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Survival Disparities by Race and Ethnicity in Early Esophageal Cancer.
Authors: Tramontano A.C. , Nipp R. , Mercaldo N.D. , Kong C.Y. , Schrag D. , Hur C. .
Source: Digestive diseases and sciences, 2018 11; 63(11), p. 2880-2888.
EPub date: 2018-08-14.
PMID: 30109578
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Estimates and predictors of health care costs of esophageal adenocarcinoma: a population-based cohort study.
Authors: Thein H.H. , Jembere N. , Thavorn K. , Chan K.K.W. , Coyte P.C. , de Oliveira C. , Hur C. , Earle C.C. .
Source: BMC cancer, 2018-06-27; 18(1), p. 694.
EPub date: 2018-06-27.
PMID: 29945563
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Use of Appropriate Surveillance for Patients With Nondysplastic Barrett's Esophagus.
Authors: Tavakkoli A. , Appelman H.D. , Beer D.G. , Madiyal C. , Khodadost M. , Nofz K. , Metko V. , Elta G. , Wang T. , Rubenstein J.H. .
Source: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2018 06; 16(6), p. 862-869.e3.
EPub date: 2018-02-09.
PMID: 29432922
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Yield of Higher-Grade Neoplasia in Barrett's Esophagus With Low-Grade Dysplasia Is Double in the First Year Following Diagnosis.
Authors: Rubenstein J.H. , Waljee A.K. , Dwamena B. , Bergman J. , Vieth M. , Wani S. .
Source: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2018 09; 16(9), p. 1529-1530.
EPub date: 2018-01-04.
PMID: 29307847
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Patient decision-making and clinical outcomes following endoscopic therapy or esophagectomy for Barrett's neoplasia.
Authors: Lockwood R. , Ozanne E. , Hur C. , Yachimski P. .
Source: Endoscopy international open, 2017 Nov; 5(11), p. E1128-E1135.
EPub date: 2017-11-08.
PMID: 29124122
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Surgical vs Endoscopic Management of T1 Esophageal Adenocarcinoma: A Modeling Decision Analysis.
Authors: Chu J.N. , Choi J. , Tramontano A. , Morse C. , Forcione D. , Nishioka N.S. , Abrams J.A. , Rubenstein J.H. , Kong C.Y. , Inadomi J.M. , et al. .
Source: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2018 03; 16(3), p. 392-400.e7.
EPub date: 2017-11-24.
PMID: 29079222
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Presentation and Epidemiology of Gastroesophageal Reflux Disease.
Authors: Richter J.E. , Rubenstein J.H. .
Source: Gastroenterology, 2018 01; 154(2), p. 267-276.
EPub date: 2017-08-03.
PMID: 28780072
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Cost Effectiveness of Screening Patients With Gastroesophageal Reflux Disease for Barrett's Esophagus With a Minimally Invasive Cell Sampling Device.
Authors: Heberle C.R. , Omidvari A.H. , Ali A. , Kroep S. , Kong C.Y. , Inadomi J.M. , Rubenstein J.H. , Tramontano A.C. , Dowling E.C. , Hazelton W.D. , et al. .
Source: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2017 Sep; 15(9), p. 1397-1404.e7.
EPub date: 2017-02-24.
PMID: 28238953
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The Impact of a Prior Diagnosis of Barrett's Esophagus on Esophageal Adenocarcinoma Survival.
Authors: Tramontano A.C. , Sheehan D.F. , Yeh J.M. , Kong C.Y. , Dowling E.C. , Rubenstein J.H. , Abrams J.A. , Inadomi J.M. , Schrag D. , Hur C. .
Source: The American journal of gastroenterology, 2017 Aug; 112(8), p. 1256-1264.
EPub date: 2017-04-04.
PMID: 28374815
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Radiofrequency Ablation of Barrett's Esophagus Reduces Esophageal Adenocarcinoma Incidence and Mortality in a Comparative Modeling Analysis.
Authors: Kroep S. , Heberle C.R. , Curtius K. , Kong C.Y. , Lansdorp-Vogelaar I. , Ali A. , Wolf W.A. , Shaheen N.J. , Spechler S.J. , Rubenstein J.H. , et al. .
Source: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2017 09; 15(9), p. 1471-1474.
EPub date: 2017-01-12.
PMID: 28089850
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Endoscopic therapy versus surgery for T1 colon cancer: defining model clinical practice.
Authors: Yachimski P. , Hur C. .
Source: Gastrointestinal endoscopy, 2016 12; 84(6), p. 995-996.
PMID: 27855802
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The Race-Specific Incidence of Esophageal Squamous Cell Carcinoma in Individuals With Exposure to Tobacco and Alcohol.
Authors: Prabhu A. , Obi K. , Lieberman D. , Rubenstein J.H. .
Source: The American journal of gastroenterology, 2016 12; 111(12), p. 1718-1725.
EPub date: 2016-08-30.
PMID: 27575710
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Proton Pump Inhibitors and Dementia Incidence.
Authors: Nguyen L. , Hur C. .
Source: JAMA neurology, 2016-08-01; 73(8), p. 1027-8.
PMID: 27322752
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A Molecular Clock Infers Heterogeneous Tissue Age Among Patients with Barrett's Esophagus.
Authors: Curtius K. , Wong C.J. , Hazelton W.D. , Kaz A.M. , Chak A. , Willis J.E. , Grady W.M. , Luebeck E.G. .
Source: PLoS computational biology, 2016 05; 12(5), p. e1004919.
EPub date: 2016-05-11.
PMID: 27168458
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Predicting Lymph Node Metastases in Superficial Esophageal Adenocarcinoma.
Authors: Tavakkoli A. , Prabhu A. , Rubenstein J.H. .
Source: Gastroenterology, 2016 06; 150(7), p. 1680-1682.
EPub date: 2016-04-29.
PMID: 27140494
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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.
EPub date: 2014-03-26.
PMID: 24681073
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