Background: The incidence of esophageal adenocarcinoma esophagus has risen at a rate faster than any other malignancy. This increase parallels an increased prevalence in esophageal adenocarcinoma's primary predisposing lesion, Barrett's metaplasia. The explanation for these changes has been elusive. In addition, there have been no significant outcomes studies of whether endoscopic surveillance of Barrett's metaplasia causes a significant decrease in cancer stage or improved survival. This proposal's overall goal is developing a series of investigations on the topics of Barrett's metaplasia/esophageal adenocarcinoma. These projects, combined with rigorous formal methodological training, will provide the candidate with skills in study design, case-control and cohort studies, database management, questionnaire development/implementation, survival analysis, multivariate analysis, and training in cost-effectiveness analysis. Protocols: A. Perform a case-control study and survival analysis using Northern California Kaiser Permanente (NCKP) esophageal cancer patients from 1990-1997 to determine whether use of endoscopy is associated with a lower stage of disease and improved survival. B. Perform a case-control study of patients with Barrett's metaplasia to evaluate pharmacologic and dietary risk factors for this pre-malignant condition. C. Establish the group of Barrett's metaplasia patients as a cohort for future follow-up studies of neoplastic progression, natural history, and risk stratification. When completed, this study will provide needed information on absolute risk of adenocarcinoma in different risk groups and allow completion of informed cost-effectiveness analyses of surveillance programs. Conclusion: The proposed studies, combined with formal education and mentoring, should substantially increase our knowledge of these cancers, and foster the candidate's development into an independent researcher in gastrointestinal disease epidemiology and outcomes.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08DK002697-04
Application #
6682829
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Podskalny, Judith M,
Project Start
2000-03-01
Project End
2004-12-31
Budget Start
2003-01-01
Budget End
2003-12-31
Support Year
4
Fiscal Year
2003
Total Cost
$121,770
Indirect Cost
Name
Kaiser Foundation Research Institute
Department
Type
DUNS #
150829349
City
Oakland
State
CA
Country
United States
Zip Code
94612
Bakr, Omar; Zhao, Wei; Corley, Douglas (2018) Gastroesophageal Reflux Frequency, Severity, Age of Onset, Family History and Acid Suppressive Therapy Predict Barrett Esophagus in a Large Population. J Clin Gastroenterol 52:873-879
Schneider, Jennifer L; Zhao, Wei K; Corley, Douglas A (2015) Aspirin and nonsteroidal anti-inflammatory drug use and the risk of Barrett's esophagus. Dig Dis Sci 60:436-43
Kubo, Ai; Block, Gladys; Quesenberry Jr, Charles P et al. (2014) Dietary guideline adherence for gastroesophageal reflux disease. BMC Gastroenterol 14:144
Corley, D A; Kubo, A; Levin, T R et al. (2009) Race, ethnicity, sex and temporal differences in Barrett's oesophagus diagnosis: a large community-based study, 1994-2006. Gut 58:182-8
Kubo, Ai; Levin, Theodore R; Block, Gladys et al. (2009) Alcohol types and sociodemographic characteristics as risk factors for Barrett's esophagus. Gastroenterology 136:806-15
Corley, Douglas A; Kubo, Ai; DeBoer, Jolanda et al. (2009) Diagnosing Barrett's esophagus: reliability of clinical and pathologic diagnoses. Gastrointest Endosc 69:1004-10
Kubo, Ai; Levin, T R; Block, Gladys et al. (2009) Cigarette smoking and the risk of Barrett's esophagus. Cancer Causes Control 20:303-11
Corley, Douglas A; Kubo, Ai; Levin, T R et al. (2008) Helicobacter pylori and gastroesophageal reflux disease: a case-control study. Helicobacter 13:352-60
Kubo, Ai; Levin, Theodore R; Block, Gladys et al. (2008) Dietary antioxidants, fruits, and vegetables and the risk of Barrett's esophagus. Am J Gastroenterol 103:1614-23;quiz 1624
Kubo, Ai; Levin, T R; Block, Gladys et al. (2008) Dietary patterns and the risk of Barrett's esophagus. Am J Epidemiol 167:839-46

Showing the most recent 10 out of 24 publications