The incidence of esophageal adenocarcinoma has been rising rapidly over the past two decades for unclear reasons. The most important risk factor for this cancer is Barrett's esophagus, a metaplastic condition in which the squamous mucosa of the esophagus is replaced by a specialized columnar epithelium in response to acid-, and possibly bile-reflux. Approximately 10% of individuals with chronic gastroesophageal reflux disease develop Barrett's esophagus and 0.5% of those with this condition progress to cancer annually. Nonetheless, there has been little systematic research into understanding the risk factors for Barrett's metaplasia. The candidate for this award proposes to use the resources of a large, ongoing, prospective cohort study, the Nurses' Health Study, to identify potential modifiable risk factors such as body mass index, cigarette and alcohol use, non-steroidal anti-inflammatory drug use, and dietary habits. The prospective collection of exposure information prior to disease diagnosis removes the biases inherent in retrospective studies and provides a unique investigative opportunity to clarify associations between various exposures and the development of Barrett's esophagus. Completion of this project will improve our understanding of this common pre-malignant condition and perhaps provide further insight into its pathogenesis. In addition, this project will allow the candidate to gain invaluable experience in database analysis and clinical epidemiology. The candidate will undergo formal coursework in nutritional epidemiology and advanced biostatistics. The research will be performed under the mentorship of Dr. Charles Fuchs and Dr. M. Michael Wolfe, well-established investigators in health-services research. At the completion on the project, the candidate will have gained the experience to become an independent researcher in clinical epidemiology.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08DK070706-04
Application #
7392317
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Podskalny, Judith M,
Project Start
2005-05-01
Project End
2010-04-30
Budget Start
2008-05-01
Budget End
2009-04-30
Support Year
4
Fiscal Year
2008
Total Cost
$128,210
Indirect Cost
Name
Boston Medical Center
Department
Type
DUNS #
005492160
City
Boston
State
MA
Country
United States
Zip Code
02118
Calderwood, Audrey H; Jacobson, Brian C (2010) Comprehensive validation of the Boston Bowel Preparation Scale. Gastrointest Endosc 72:686-92
Jacobson, Brian C; Madhani, Sheila J; Schmitt, Colleen M (2009) Gastroenterologists' experience with the 2007 Physician Quality Reporting Initiative: a demonstration project. Gastrointest Endosc 69:530-4
Lai, Edwin J; Calderwood, Audrey H; Doros, Gheorghe et al. (2009) The Boston bowel preparation scale: a valid and reliable instrument for colonoscopy-oriented research. Gastrointest Endosc 69:620-5
Jacobson, B C; Chan, A T; Giovannucci, E L et al. (2009) Body mass index and Barrett's oesophagus in women. Gut 58:1460-6
Jacobson, Brian C; Triadafilopoulos, George (2009) An introduction to ""obesity and the endoscopist:"" a GI special series. Gastrointest Endosc 70:751
Jacobson, Brian C; Moy, Beverly; Colditz, Graham A et al. (2008) Postmenopausal hormone use and symptoms of gastroesophageal reflux. Arch Intern Med 168:1798-804
Jacobson, B C; Gerson, L B (2008) The inaccuracy of ICD-9-CM Code 530.2 for identifying patients with Barrett's esophagus. Dis Esophagus 21:452-6
Jacobson, Brian C (2008) Body mass index and the efficacy of acid-mediating agents for GERD. Dig Dis Sci 53:2313-7
Jacobson, Brian C; Shami, Vanessa M; Faigel, Douglas O et al. (2007) Through-the-scope balloon dilation for endoscopic ultrasound staging of stenosing esophageal cancer. Dig Dis Sci 52:817-22
Jacobson, Brian C; Vander Vliet, Martha B; Hughes, Michael D et al. (2007) A prospective, randomized trial of clear liquids versus low-fat solid diet as the initial meal in mild acute pancreatitis. Clin Gastroenterol Hepatol 5:946-51;quiz 886

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