Controlling Esophageal Cancer: A Collaborative Modeling Approach

控制食管癌：协作建模方法

• 批准号: 8969418
• 负责人: Chin Hur
• 金额: $ 118.69万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8969418
• 关键词: Address; Adenocarcinoma; American; Area; Asia; Barrett Esophagus; Biological Markers; Biopsy; Cancer Control; Cancer Intervention and Surveillance Modeling Network; China; Chinese People; Clinical; Data; Decision Aid; Diagnosis; Dysplasia; Endoscopy; Esophageal Adenocarcinoma; Esophageal Squamous Cell Carcinoma; Evaluation; Exercise; Foundations; Funding; Gastroesophageal reflux disease; Genomics; Goals; Guidelines; Health Policy; Healthcare; Histologic; Incidence; Individual; Intervention; Knowledge; Malignant Neoplasms; Malignant neoplasm of esophagus; Medical; Methods; Mission; Modeling; Morbidity - disease rate; Natural History; Outcome; Output; Patients; Policies; Population; Premalignant; Prevention; Prevention strategy; Public Health; Publications; Quality of life; Research; Research Project Grants; Resources; Risk; Risk Factors; Squamous cell carcinoma; Staging; Stratification; Structure; Survival Rate; Symptoms; Technology; Western World; Work; burden of illness; clinical predictors; comparative; experience; high risk; improved; men; models and simulation; mortality; preference; prototype; public health relevance; screening; surveillance strategy; tool

 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.

 描述（由申请人提供）：控制食管癌：一种协作模型，是为了促进我们对癌症控制的理解，以减少与此相比的负担食管癌的类型）和鳞状细胞癌（ESCC）。迄今为止，主要的筛查和生产努力针对患者使用内窥镜检查和活检，以识别Barrett食管（BE）的患者进行内窥镜监测，没有任何牢固的监视策略。有效，生存率较差，很大一部分在后期和入侵阶段继续被诊断出来，估计有40-6亿美国人的GERD D 3-1200万BE，该患者的管理大大增加了EAC风险除了不确定的长期福利外，还成为一个重要的公共卫生问题，当前的无概括策略可能会遭受夸张和iA的态度，在经历大量的医疗资源的同时，会影响生活的高音。强大的基础，要唤起talesess筛查策略：具体来说，对新筛查技术，预防和生物标志物等尖端增强的评估。虽然限制了过度处理和精神，但这些建模工作将个性化帕特塔（Patieta）构建决策援助，这将通过使管理层与个人筛查的偏好保持一致，这将使患者负担在EAC上。 ，在亚洲的部分地区，例如中国的遗嘱。致病性癌症的最终目标。