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Sponsored by: |
Midwest Biomedical Research Foundation |
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Information provided by: | Kansas City Veteran Affairs Medical Center |
ClinicalTrials.gov Identifier: | NCT00574327 |
The purpose of this study is to determine or evaluate the risk factors such as smoking, family history etc. that cause esophageal cancer and to determine the genetic changes that lead to esophageal cancer. The investigators hypothesis is that systematic collection of data on the natural history of GERD and BE patients and risk factors for development of BE in patients with chronic GERD and progression of BE to dysplasia and adenocarcinoma will provide useful information to develop a decision model for risk stratification and risk reduction strategies in these patients. As of June 11, 2009 148 patients have been enrolled at the Kansas City VA Medical Center.
Condition |
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Barrett's Esophagus Gastroesophageal Reflux Disease Esophageal Adenocarcinoma |
Study Type: | Observational |
Study Design: | Case Control, Prospective |
Official Title: | A Prospective Study To Define The Role Of Various Factors In Development And Progression Of Gastroesophageal Reflux Disease (GERD) And Barrett's Esophagus And The Creation Of A Registry. |
Serum samples from participating patients will be collected and frozen for measurements of insulin, glucose, lipid panel, CRP and adiponectin levels. Biopsies obtained from esophagus during endoscopy and blood samples will be frozen for future biomarker and cDNA microarray studies and histochemistry.
Estimated Enrollment: | 3000 |
Study Start Date: | January 2006 |
Estimated Study Completion Date: | January 2012 |
Groups/Cohorts |
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A
Patients with documented BE with and without dysplasia (LGD or HGD) that will undergo surveillance endoscopies dictated by the grade of dysplasia.
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B
Patients undergoing endoscopy for evaluation of GERD symptoms.
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C
The control group would include patients undergoing upper endoscopy for reasons other than stated above, such as evaluation of iron deficiency anemia, weight loss, positive fecal occult blood, etc.
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Symptoms of gastroesophageal reflux are common. It affects at least 40% of the adult American population and 40 million American adults experience reflux symptoms on a regular basis. Gastroesophageal reflux disease (GERD) typically affects Caucasians and older males. It is a significant risk factor for development of Barrett's esophagus (BE) and esophageal adenocarcinoma. Approximately 10-15% of patients with chronic GERD are diagnosed with BE, a premalignant lesion for esophageal adenocarcinoma. Adenocarcinoma of the esophagus continues to be the most rapidly increasing incidence cancer in the United States. Based on studies evaluating screening/surveillance strategies, it is clear that it is imperative to identify risk factors that would target those patients with gastroesophageal reflux disease (GERD) and BE that may benefit from screening and surveillance strategies, yet also be practical and cost-effective. A better understanding of the events surrounding the development of BE in patients with chronic GERD, development of dysplastic changes in patients with BE and progression of BE to adenocarcinoma may ultimately help in identifying those patients at increased risk. Thus, our hypothesis is that systematic collection of data on the natural history of GERD and BE patients and risk factors for development of BE in patients with chronic GERD and progression of BE to dysplasia and adenocarcinoma will provide useful information to develop a decision model for risk stratification and risk reduction strategies in these patients.
This model will be a useful tool leading to a reduction in overall health care costs.
The study will be conducted at the Kansas City Department of Veterans Affairs Medical Center. This is a prospective cohort study designed to analyze the epidemiologic and genetic factors relevant to development of BE in patients with GERD and its subsequent progression to dysplasia and adenocarcinoma. 1) The consenting patients as well as controls (2:1 ratio) will be asked to fill validated questionnaire on severity of GERD and food frequency. Data regarding medications, family history and social history will also be collected. 2) The endoscopy and pathology reports will be browsed for length of Barrett's esophagus confirmed by histology, length of hiatal hernia and presence of helicobacter pylori. 3) Serum samples from participating patients will be collected and frozen for measurements of insulin, glucose, lipid panel, CRP and adiponectin levels. Biopsies obtained from esophagus during endoscopy and blood samples would be frozen for future biomarker and cDNA microarray studies and histochemistry. Approximately10-20% of the adult population has GERD and 0.5 to 2% of the adult population (1-4 million individuals) is estimated to have BE and it is a known precursor to esophageal adenocarcinoma. However, we are not yet able to reliably identify those individuals with GERD that are at risk for developing BE and with BE who are at high risk for progressing to esophageal adenocarcinoma. The identification of risk factors as the ultimate goal of this study will enable us to better identify the high-risk patients and provide early intervention and therapeutic strategies in a cost-effective manner.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | Yes |
Sampling Method: | Non-Probability Sample |
Those presenting to the Kansas City VA endoscopy laboratory for their "standard BE surveillance" endoscopy. Patients with a history of BE will be identified and contacted from the existing databank. Patients with newly diagnosed BE in the endoscopy laboratory after their procedure is completed and biopsy results are available.Patients undergoing upper endoscopy for evaluation of GERD symptoms. Control group of patients undergoing upper endoscopy for any reason other than the ones stated above.
Inclusion Criteria:
Exclusion Criteria:
Contact: April D Higbee, RN, BSN | 816-861-4700 ext 57456 | april.higbee@va.gov |
United States, Missouri | |
Department of Veterans Affairs Medical Center | Recruiting |
Kansas City, Missouri, United States, 64128 | |
Principal Investigator: Prateek Sharma, MD | |
Sub-Investigator: Ajay Bansal, MD | |
Sub-Investigator: Amit Rastogi, MD | |
Sub-Investigator: Sharad Mathur, MD | |
Sub-Investigator: Dean Reker, PhD | |
Sub-Investigator: Prashant Pandya, DO |
Principal Investigator: | Prateek Sharma, MD | Department of Veterans Affairs Medical Center of Kansas City |
Responsible Party: | Midwest Biomedical Research Foundation ( Prateek Sharma, MD ) |
Study ID Numbers: | PS0035 |
Study First Received: | December 14, 2007 |
Last Updated: | February 3, 2009 |
ClinicalTrials.gov Identifier: | NCT00574327 History of Changes |
Health Authority: | United States: Federal Government |
Role Registry Barrett's Esophagus |
Gastrointestinal Diseases Disease Progression Gastroesophageal Reflux Carcinoma Esophageal Motility Disorders Deglutition Disorders Digestive System Abnormalities Digestive System Diseases |
Barrett Syndrome Esophageal Disorder Barrett Esophagus Esophageal Diseases Adenocarcinoma Congenital Abnormalities Neoplasms, Glandular and Epithelial |
Neoplasms by Histologic Type Gastrointestinal Diseases Gastroesophageal Reflux Carcinoma Esophageal Motility Disorders Deglutition Disorders Neoplasms |
Digestive System Abnormalities Digestive System Diseases Barrett Esophagus Esophageal Diseases Adenocarcinoma Neoplasms, Glandular and Epithelial |