Early Detection of Esophageal Cancer

 

Study Partners:

Lake Cumberland Regional Hospital Cancer Treatment Center
Endoscopists and Gastroenterologists in Kentucky’s 5th District

Study Staff:

Dr. Nicholas Nickl, Dr. Houssam Mardini, and Ms. Sarah Turner

Primary Contact: Sarah Turner 1-877-267-0626

Despite advances in treatment of esophageal cancer, half of the patients are incurable when diagnosed and overall survival after diagnosis and treatment remains poor.

Barrett’s esophagus, a condition associated with long-term gastroesophageal reflux disease (GERD), is a precursor of esophageal adenocarcinoma(AdCA). We know little about the natural history, effective management, and other risk factors associated with Barrett’s esophagus in the United States. Certain hosts, environments, and intervention-related factors may be associated with the development of Barrett’s esophagus. Identifying these factors and implementing public health measures such as educational programs, screening, and surveillance can be effective in improving disease related outcomes.

The counties of Pulaski, Whitley, and Laurel have incidence rates of esophageal cancer that are in general, higher than national or Kentucky rates. Thus, this area is particularly well suited for a study of esophageal cancer. We recruit participants from these counties, and other 5th district counties, with long-standing GERD and/or Barrett’s esophagus.

The study investigates the effectiveness of the current recommendations for screening and surveillance of Barrett’s esophagus in preventing advanced dysplasia and/or cancer.

In addition, we are looking at a variety of risk factors, including

  • Dietary factors
  • Duration, frequency, and severity of reflux symptoms
  • Use of medication to control symptoms
  • Family history of Barrett’s esophagus and/or esophageal cancer

In a future step, we plan to identify potential non-invasive markers for risk stratification, screening and surveillance of Barrett’s esophagus and esophageal cancer. Furthermore, we will compare various treatments for advanced dysplasia by using medical, endoscopic or surgical interventions.


How does this study work?

Interested people living in the 5th District call toll free 1-877-267-0626 to reserve a space in an upcoming training session held in their area.

Training session topics:

  • Symptoms associated with GERD
  • Layman’s definition of Barrett’s esophagus
  • Association between GERD and Barrett’s esophagus
  • Association between Barrett’s esophagus and esophageal AdCA
  • Risk factors predisposing to GERD, Barrett’s esophagus, and esophageal AdCA
  • Benefits of screening and surveillance for earlier detection

Training session participants who want to join the esophageal study sign an informed consent to participate.

Participants are encouraged to schedule an endoscopy with their primary physician or a local endoscopist or gastroenterologist. This study does not pay for the endoscopy. Accordingly, participants need to cover this cost through personal health insurance. Consistent with current recommendations, the endoscopy will screen for the presence of Barrett’s esophagus. We recommend follow up surveillance for participants found to have Barrett’s Esophagus.  The intervals for follow up surveillance endoscopies depend on pathologic findings.

Participants inform the study coordinator (toll free 1-877-267-0626) when an endoscopy has been performed and provide contact information so that study researchers can acquire the results of the test.

Researchers will review the endoscopy findings and assign participants to one of three groups:

Group 1: No Barrett’s esophagus
Group 2: Barrett’s esophagus with no dysplasia or low-grade dysplasia
Group 3: Barrett’s esophagus with high-grade dysplasia or esophageal AdCA

Study staff follows participants from all groups for at least 3 years.

Map of 5th Congressional District

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