Comparative modeling of gastric cancer disparities and prevention in the US and globally

美国和全球胃癌差异和预防的比较模型

• 批准号: 10705668
• 负责人: Chin Hur
• 金额: $ 81.02万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10705668
• 关键词: Accounting; Address; Adult; Age; Antibiotic Resistance; Asian population; Black Populations; Calibration; Cancer Burden; Cancer Control; Cancer Etiology; Cancer Model; Caring; Categories; Cessation of life; Clinical; Country; Curative Surgery; Data; Databases; Diagnosis; Disparity; Ethnic Origin; Excision; Future; Gastric Adenocarcinoma; Goals; Helicobacter Infections; Helicobacter pylori; Hispanic Populations; Incidence; Individual; Intervention; Lesion; Malignant Neoplasms; Methodology; Modeling; Neoplasms; Outcome; Patients; Persons; Policies; Population; Positioning Attribute; Prevalence; Prevention; Prevention strategy; Primary Care; Primary Prevention; Prospective Studies; Publications; Race; Randomized, Controlled Trials; Recommendation; Regimen; Research; Risk; Risk Factors; Screening for Gastric Cancer; Second Primary Cancers; Secondary Prevention; Smoking; Stomach; Study models; Subgroup; Survival Rate; Variant; Vulnerable Populations; Work; World Health Organization; burden of illness; cancer care; cancer health disparity; cancer prevention; comparative; cost effective; cost effectiveness; disease natural history; early onset; experience; gastric cancer prevention; gastric intestinal metaplasia; high risk; high risk population; improved; innovation; malignant stomach neoplasm; minority communities; model development; models and simulation; mortality; neglect; population health; premalignant; progression risk; racial population; screening; sex; simulation; smoking cessation; surveillance strategy; tool; transmission process; trend; young woman

Gastric cancer (GC), specifically gastric adenocarcinoma, is the fifth most common cancer and the third leading cause of cancer death globally and has been categorized as a neglected cancer by the World Health Organization. In the U.S., there are stark disparities, with Blacks, Hispanics and Asians having a nearly two- fold greater risk of developing or dying from GC compared to Whites, reflecting differences in risk factors, such as Helicobacter pylori (H. pylori) infection and smoking, as well as access to primary prevention and care. Several factors are changing the landscape of GC prevention, including a better understanding of the disease natural history, new evidence on prevention from prospective studies, and anticipated results from randomized controlled trials. As early GC detection can improve survival by allowing for curative surgical or noninvasive endoscopic resection, new targeted approaches to GC prevention have the potential to markedly improve population health and reduce GC disparities within the U.S. Although H. pylori has been the primary focus of global GC prevention efforts to date, substantial variation by subpopulation in H. pylori prevalence in the U.S. and the world has accentuated the need to optimize H. pylori screen-and-treat interventions for vulnerable groups. One approach is targeted endoscopic screening of high-risk individuals. For instance, persons found to have gastric intestinal metaplasia, a precursor lesion associated with a high progression risk to gastric neoplasia, are recommended to undergo endoscopic surveillance in many countries. A critical need exists to identify effective and cost-effective strategies to address these clinical challenges in the U.S., as well as globally. This proposed work builds upon prior GC work spanning GC and H. pylori simulation modeling studies, GC secondary database analyses, and relevant methodologic and global cancer modeling publications. The research team for this proposal has a vast collective experience in simulation and comparative modeling for cancer control, clinical expertise across the spectrum of GC prevention and care, and a demonstrated track record and commitment to informing cancer care and policy. The proposed three modeling groups are well-positioned to perform and successfully complete the highly relevant project aims. The overarching goal of the proposed research is to produce innovative and paradigm-shifting changes to cancer care through a disparities-focused modeling approach targeting the most vulnerable, high-risk populations that bear the greatest burden of GC in the US, and the world. We will accomplish this goal by performing comparative modeling and completing the following aims: 1) Develop GC simulation models to estimate GC outcomes for subgroups by race and ethnicity in the U.S.; 2) Assess the impact of risk factor trends and primary prevention strategies on GC disparities; 3) Evaluate targeted secondary prevention strategies for reducing early onset-related mortality and GC disparities, and 4) Adapt the models to evaluate GC prevention policies in the global setting.

胃癌 (GC)，特别是胃腺癌，是第五大常见癌症，也是第三大常见癌症 全球癌症死亡的主要原因，已被世界卫生组织列为被忽视的癌症 组织。在美国，存在着明显的差异，黑人、西班牙裔和亚裔的比例接近两倍—— 与白人相比，罹患胃癌或死亡的风险更大，这反映了风险因素的差异，例如 幽门螺杆菌 (H. pylori) 感染和吸烟，以及获得初级预防和护理。 有几个因素正在改变GC预防的格局，包括更好地了解这种疾病 自然史、前瞻性研究预防的新证据以及随机随机试验的预期结果 对照试验。由于早期 GC 检测可以通过根治性手术或非侵入性治疗来提高生存率 内镜切除术、新的有针对性的胃癌预防方法有可能显着改善 人口健康并减少美国境内的GC差异，尽管幽门螺杆菌一直是人们关注的主要焦点 迄今为止，全球胃癌预防工作显示，美国不同亚人群的幽门螺杆菌患病率存在​​显着差异 全世界都强调需要优化弱势群体的幽门螺杆菌筛查和治疗干预措施 组。一种方法是对高危人群进行有针对性的内窥镜筛查。例如，人们被发现 患有胃肠上皮化生，这是一种与胃病进展风险高相关的前驱病变 许多国家建议接受内窥镜监测。迫切需要 确定有效且具有成本效益的策略来应对美国的这些临床挑战 与全球一样。这项提议的工作建立在之前的 GC 工作之上，涵盖 GC 和幽门螺杆菌模拟模型 研究、GC 二级数据库分析以及相关方法学和全球癌症模型 出版物。该提案的研究团队在模拟和 癌症控制的比较模型、GC 预防和护理领域的临床专业知识、 以及在为癌症护理和政策提供信息方面的良好记录和承诺。提议的三项 建模小组有能力执行并成功完成高度相关的项目目标。 拟议研究的总体目标是产生创新和范式转变 通过以差异为中心的建模方法来改变癌症护理 在美国和世界范围内，弱势、高风险人群承受着最严重的胃癌负担。我们将 通过执行比较建模并完成以下目标来实现此目标：1) 开发 GC 用于估计美国按种族和民族划分的亚组 GC 结果的模拟模型； 2) 评估 危险因素趋势和一级预防策略对 GC 差异的影响； 3）评估目标 降低早发型相关死亡率和 GC 差异的二级预防策略，以及 4) 调整 评估全球环境中GC预防政策的模型。

项目成果

Gastric Cancer:: An Update on the Rapidly Changing Characteristics and Evolving Opportunities for Interventions.

胃癌：快速变化的特征和不断变化的干预机会的最新情况。

• 发表时间: 2021-07
• 作者: Hur; Chin
• 通讯作者: Chin

Prevalence of Gastric Precursor Lesions in Countries With Differential Gastric Cancer Burden: A Systematic Review and Meta-analysis.

胃癌负担不同的国家中胃前体病变的患病率：系统评价和荟萃分析。

• 发表时间: 2024-03-02
• 作者: Mülder, Duco T;Hahn, Anne I;Huang, Robert J;Zhou, Margaret J;Blake, Benjamin;Omofuma, Omonefe;Murphy, John D;Gutiérrez;Zauber, Ann G;O'Mahony, James F;Camargo, M Constanza;Ladabaum, Uri;Yeh, Jennifer M;Hur, Chin;Lansdorp
• 通讯作者: Lansdorp

Approaches to developing de novo cancer population models to examine questions about cancer and race in bladder, gastric, and endometrial cancer and multiple myeloma: the Cancer Intervention and Surveillance Modeling Network incubator program.

开发从头癌症群体模型来检查膀胱癌、胃癌、子宫内膜癌和多发性骨髓瘤中的癌症和种族问题的方法：癌症干预和监测建模网络孵化器计划。

• DOI: 10.1093/jncimonographs/lgad021
• 发表时间: 2023-11-01
• 期刊: Journal of the National Cancer Institute. Monographs
• 作者: Yuliia Sereda;F. Alarid;N. Bickell;Su;G. A. Colditz;Chin Hur;Hawre Jalal;Evan R Myers;Tracy M Layne;Shi;Jennifer M Yeh;T. Trikalinos
• 通讯作者: T. Trikalinos

Management of Gastric Intestinal Metaplasia.

胃肠化生的治疗。

• 发表时间: 2023-08
• 作者: Rustgi, Sheila D;Zylberberg, Haley M;Hur, Chin;Shah, Shailja C
• 通讯作者: Shah, Shailja C