A Personalized Approach to Targeted Esophageal Cancer Screening

针对性食管癌筛查的个性化方法

基本信息

批准号：
10661535
负责人：
Chin Hur
金额：
$ 50.78万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-08 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10661535
关键词：
Award Biopsy Cancer Control Case Fatality Rates Cells Characteristics Clinical Research Collaborations Colorectal Cancer Cost Analysis Data Devices Effectiveness Endoscopy Esophageal Adenocarcinoma Esophagus Financial cost Foundations Funding Goals Health system Healthcare Systems Histologic Incidence Individual Life Expectancy Malignant Neoplasms Malignant neoplasm of esophagus Mass Screening Methods Modality Modeling Morbidity - disease rate Natural History Patients Performance Population Prevention Primary Care Procedures Provider Recommendation Regimen Research Research Personnel Research Project Grants Risk Sampling Screening for cancer Technology Testing Western World Work burden of illness cost cost effective cost effectiveness cost estimate experience future implementation high risk implementation barriers improved individual patient innovation insight member models and simulation mortality new technology novel novel strategies personalized approach personalized screening primary care setting profiles in patients screening screening program

项目摘要

The goal of the project is to diminish the morbidity and mortality associated with esophageal cancer as patients with this cancer continue to suffer from extremely poor survival and high case-fatality rates. Esophageal adenocarcinoma (EAC) is the most common histologic type of esophageal malignancy in the US and has experienced an alarmingly rapid and largely unexplained rise in incidence over the past four decades in much of the western world. Previous attempts to curb the morbidity and mortality associated with EAC in the US have focused on an endoscopic screening, which is invasive and costly. However, innovative new technologies for esophageal cancer screening that are both less invasive and costly have created the opportunity to lower the bar for screening to where it could be a realistic option, particularly for those who are higher risk. While the performance metrics of the device are important, equally critical are identifying and resolving barriers to implementation. We propose to study potential factors for patients, providers and health care systems that could impede screening programs. This R01 proposal will leverage a previously developed and validated natural history simulation model of EAC. The PI has made significant contributions to the fields of esophageal cancer screening, prevention and treatment utilizing the EAC model to assess and analyze critical aspects of EAC cancer control. The prior work and model will provide an exceptionally strong foundation for the current research project. The research team is comprised of experienced investigators who provide the broad and complementary expertise necessary for this project and have a track record of successful collaboration. The overarching premise of our proposal is that novel approaches to esophageal cancer screening have the potential to improve EAC mortality, but that the successful implementation and population impact will depend on: 1) the screening modality characteristics; 2) patient, provider, and health system’s barriers; and 3) the profile of the patients to be screened. We will accomplish these project goals by completing four specific aims. In Aim 1 we will use our validated simulation model of esophageal cancer to test and assess whether a cell sampling device can be cost-effective for population screening. In Aim 2 we will study potential patient, provider and health system barriers to esophageal cancer screening. For Aim 3 we will personalize screening by determining which patient profiles will benefit from screening. Finally, in Aim 4 will assess the population cancer control impact of the potential implementation of the esophageal cancer screening strategy defined by the prior aims. By award period end, we will have developed a personalized approach to targeted EAC screening that is rational and cost-effective.

该项目的目的是减少与患者相关的食管癌的发病率和死亡率随着这种癌症，生存率和高病态率的较高。食管腺癌（EAC）是美国食管恶性肿瘤最常见的组织学类型，具有在过去的四十年中，事件的迅速迅速且大致意外上升西方世界。以前试图遏制美国与EAC相关的发病率和死亡率专注于内窥镜检查，这是侵入性和昂贵的。但是，创新的新技术对于食管癌筛查，既没有侵入性又昂贵的食管癌，创造了降低的机会筛选的标准可能是现实的选择，尤其是对于那些风险较高的人。虽然该设备的性能指标很重要，但同样重要的是识别和解决障碍实施。我们建议研究患者，提供者和医疗保健系统的潜在因素可能阻碍筛选计划。该R01提案将利用EAC的先前开发和验证的自然历史模拟模型。 PI为食管癌筛查，预防和治疗做出了重大贡献使用EAC模型评估和分析EAC癌症控制的关键方面。先前的工作和模型将为当前的研究项目提供异常强大的基础。研究小组完成经验丰富的调查人员提供了该项目必要的广泛而完整的专业知识，拥有成功合作的记录。我们提议的总体信念是，食管癌筛查的新方法具有提高EAC死亡率的潜力，但是成功的实施和人口影响将取决于在：1）筛选方式特征； 2）患者，提供者和卫生系统的障碍； 3）要筛查的患者的轮廓。我们将通过完成四个具体目标来实现这些项目目标。在AIM 1中，我们将使用经过验证的食管癌的模拟模型来测试和评估细胞是否是否抽样设备对于人口筛查可能具有成本效益。在AIM 2中，我们将研究潜在的患者，食管癌筛查的提供者和卫生系统障碍。对于目标3，我们将个性化筛选通过确定哪些患者概况将受益于筛查。最后，在AIM 4中将评估人口癌症控制对食管癌筛查策略的潜在实施的影响先前的目标。到颁奖期结束时，我们将开发一种个性化的方法来进行针对性的EAC筛查理性和成本效益。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The Optimal Age to Stop Endoscopic Surveillance of Patients With Barrett's Esophagus Based on Sex and Comorbidity: A Comparative Cost-Effectiveness Analysis.

DOI：
10.1053/j.gastro.2021.05.003
发表时间：
2021-08
期刊：
Gastroenterology
影响因子：
29.4
作者：
Omidvari AH;Hazelton WD;Lauren BN;Naber SK;Lee M;Ali A;Seguin C;Kong CY;Richmond E;Rubenstein JH;Luebeck GE;Inadomi JM;Hur C;Lansdorp-Vogelaar I
通讯作者：
Lansdorp-Vogelaar I

Utilization of Surveillance Endoscopy for Barrett's Esophagus in Medicare Enrollees.