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Cancer Intervention and Surveillance Modeling Network

Modeling to guide public health research and priorities

Controlling Esophageal Cancer in the US.: A Colloraborative Modeling Project

Principal Investigator: Chin Hur, MD, MPH
Institution: Massachusetts General Hospital

Co-PIs:

Georg Luebeck, PhD Fred Hutchinson Cancer Research Center
John Inadomi, MD University of Washington

Grant Number: 1U01CA152926-01

Abstract: The ultimate goal of the proposed research project is to advance our understanding of esophageal cancer and the impact of cancer control interventions aimed at diminishing the burden of this disease. We will accomplish this goal through a collaborative and comparative modeling project.

The incidence of esophageal adenocarcinoma (EAC) has been rising at an alarming rate over the past four decades. Although the absolute number of EAC cases per year remains too low to screen the general population, targeted screening may be appropriate. Heartburn, the primary symptom of gastroesophageal reflux disease (GERD), affects 40-60 million Americans and can lead to Barrett's esophagus (BE), a premalignant condition associated with the greatest risk of developing EAC. Because of the significant number of individuals affected with GERD and BE, the management of these patients has become a public health issue. However, an accepted screening or surveillance program for EAC has not been proposed.

The goal of National Cancer Institute's (NCI) Cancer Intervention and Surveillance Modeling Network (CISNET), and a broader theme for our research proposal, is to bring together different simulation models, embracing differences in model structure to improve the overall understanding of a cancer's natural history and to improve model projections. Our application is in response to CISNET's recent expansion to include esophageal cancer as one of the targeted cancers within its network.

As a new cancer group, we have the distinct opportunity to perform analyses that provide much need data through evidence synthesis using a simulation modeling approach. Our innovative collaboration will perform comparative modeling that focuses on, but is not limited to, determining the effectiveness of clinically relevant issues in esophageal cancer, the incorporation of biomarkers, and the dissemination of data to inform cancer control policy.

The investigators and the institutions assembled for this project have expertise in all facets of simulation disease modeling, clinical aspects of esophageal cancer, and a proven history of research and collaborations, providing assurance that the project's goals will be achieved in this productive environment. The research 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 mortality and morbidity.