56 results on '"Corley, Douglas A."'
Search Results
2. Evaluating Different Approaches for Calculating Adenoma Detection Rate: Is Screening Colonoscopy the Gold Standard?
- Author
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Corley DA, Jensen CD, Chubak J, Schottinger JE, Halm EA, and Udaltsova N
- Subjects
- Humans, Colonoscopy, Early Detection of Cancer, Colonic Polyps diagnosis, Adenoma diagnosis, Colorectal Neoplasms diagnosis
- Published
- 2023
- Full Text
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3. Effect of Helicobacter pylori Eradication Therapy on the Incidence of Noncardia Gastric Adenocarcinoma in a Large Diverse Population in the United States.
- Author
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Li D, Jiang SF, Lei NY, Shah SC, and Corley DA
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- Humans, United States epidemiology, Retrospective Studies, Incidence, Anti-Bacterial Agents therapeutic use, Stomach Neoplasms epidemiology, Stomach Neoplasms prevention & control, Stomach Neoplasms drug therapy, Helicobacter pylori, Helicobacter Infections diagnosis, Helicobacter Infections drug therapy, Helicobacter Infections epidemiology, Adenocarcinoma epidemiology, Adenocarcinoma prevention & control, Adenocarcinoma drug therapy
- Abstract
Background & Aims: High-quality data regarding the effect of Helicobacter pylori eradication on the risk of noncardia gastric adenocarcinoma (NCGA) remain limited in the United States. We investigated the incidence of NCGA after H pylori eradication therapy in a large, community-based US population., Methods: We performed a retrospective cohort study of Kaiser Permanente Northern California members who underwent testing and/or treatment for H pylori between 1997 and 2015 and were followed through December 31, 2018. The risk of NCGA was evaluated using the Fine-Gray subdistribution hazard model and standardized incidence ratios., Results: Among 716,567 individuals with a history of H pylori testing and/or treatment, the adjusted subdistribution hazard ratios and 95% confidence intervals of NCGA for H pylori-positive/untreated and H pylori-positive/treated individuals were 6.07 (4.20-8.76) and 2.68 (1.86-3.86), respectively, compared with H pylori-negative individuals. When compared directly with H pylori-positive/untreated individuals, subdistribution hazard ratios for NCGA in H pylori-positive/treated were 0.95 (0.47-1.92) at <8 years and 0.37 (0.14-0.97) ≥8 years of follow-up. Compared with the Kaiser Permanente Northern California general population, standardized incidence ratios (95% confidence interval) of NCGA steadily decreased after H pylori treatment: 2.00 (1.79-2.24) ≥1 year, 1.01 (0.85-1.19) ≥4 years, 0.68 (0.54-0.85) ≥7 years, and 0.51 (0.38-0.68) ≥10 years., Conclusion: In a large, diverse, community-based population, H pylori eradication therapy was associated with a significantly reduced incidence of NCGA after 8 years compared with no treatment. The risk among treated individuals became lower than the general population after 7 to 10 years of follow-up. The findings support the potential for substantial gastric cancer prevention in the United States through H pylori eradication., (Copyright © 2023 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
- Full Text
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4. Post-Colonoscopy Colorectal Cancer Etiologies in a Large Integrated US Health Care Setting.
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Leung LJ, Lee JK, Merchant SA, Jensen CD, Alam A, and Corley DA
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- Humans, Risk Factors, Delivery of Health Care, Early Detection of Cancer adverse effects, Colonoscopy adverse effects, Colorectal Neoplasms etiology
- Published
- 2023
- Full Text
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5. Age-Stratified Prevalence and Predictors of Neoplasia Among U.S. Adults Undergoing Screening Colonoscopy in a National Endoscopy Registry.
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Liang PS, Williams JL, Dominitz JA, Corley DA, and Zauber AG
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- Adult, Aged, Colonoscopy, Early Detection of Cancer, Female, Humans, Male, Middle Aged, Prevalence, Registries, Risk Factors, Adenoma diagnosis, Adenoma epidemiology, Adenoma pathology, Colonic Polyps pathology, Colorectal Neoplasms diagnosis, Colorectal Neoplasms epidemiology, Colorectal Neoplasms pathology
- Abstract
Background & Aims: Several U.S. organizations now recommend starting average-risk colorectal cancer screening at age 45 years, but the prevalence of colonic neoplasia in individuals younger than 50 years has not been well characterized. We used a national endoscopic registry to calculate age-stratified prevalence and predictors of colorectal neoplasia., Methods: Outpatient screening colonoscopies performed during 2010-2020 in the GI Quality Improvement Consortium registry were analyzed. We measured the prevalence of advanced neoplasia and adenomas by age, sex, and race/ethnicity, as well as the prevalence ratio of neoplasia compared with the reference group of 50- to 54-year-olds. Multivariable logistic regression models were used to identify predictors of neoplasia., Results: We identified 3,928,727 screening colonoscopies, of which 129,736 (3.3%) were performed on average-risk individuals younger than 50 years. The prevalence of advanced neoplasia was 6.2% for 50- to 54-year-olds and 5.0% (prevalence ratio, 0.81; 95% confidence interval, 0.78-0.83) for average-risk 45- to 49-year-olds. Men had higher prevalence of neoplasia than women for all age groups. White individuals had higher prevalence of advanced neoplasia than persons of other racial/ethnic groups in most age groups, which was partially driven by serrated lesions. On multivariable regression, White individuals had higher odds of advanced neoplasia than Black, Hispanic, and Asian individuals in both younger and older age groups., Conclusions: In a large U.S. endoscopy registry, the prevalence of advanced neoplasia in 45- to 49-year-olds was substantial and supports beginning screening at age 45 years. White individuals had higher risk of advanced neoplasia than Black, Hispanic, and Asian individuals across the age spectrum. These findings may inform adenoma detection benchmarks and risk-based screening strategies., (Published by Elsevier Inc.)
- Published
- 2022
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6. Impact of the COVID-19 Pandemic on Fecal Immunochemical Testing, Colonoscopy Services, and Colorectal Neoplasia Detection in a Large United States Community-based Population.
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Lee JK, Lam AY, Jensen CD, Marks AR, Badalov J, Layefsky E, Kao K, Ho NJ, Schottinger JE, Ghai NR, Carlson CM, Halm EA, Green B, Li D, Corley DA, and Levin TR
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- Adolescent, Adult, Aged, Aged, 80 and over, Colonoscopy methods, Community Health Services, Early Detection of Cancer methods, Feces, Humans, Mass Screening methods, Middle Aged, Occult Blood, Pandemics, Retrospective Studies, United States epidemiology, Young Adult, COVID-19 diagnosis, COVID-19 epidemiology, Colorectal Neoplasms diagnosis, Colorectal Neoplasms epidemiology
- Abstract
Background & Aims: The COVID-19 pandemic has affected clinical services globally, including colorectal cancer (CRC) screening and diagnostic testing. We investigated the pandemic's impact on fecal immunochemical test (FIT) screening, colonoscopy utilization, and colorectal neoplasia detection across 21 medical centers in a large integrated health care organization., Methods: We performed a retrospective cohort study in Kaiser Permanente Northern California patients ages 18 to 89 years in 2019 and 2020 and measured changes in the numbers of mailed, completed, and positive FITs; colonoscopies; and cases of colorectal neoplasia detected by colonoscopy in 2020 vs 2019., Results: FIT kit mailings ceased in mid-March through April 2020 but then rebounded and there was an 8.7% increase in kits mailed compared with 2019. With the later mailing of FIT kits, there were 9.0% fewer FITs completed and 10.1% fewer positive tests in 2020 vs 2019. Colonoscopy volumes declined 79.4% in April 2020 compared with April 2019 but recovered to near pre-pandemic volumes in September through December, resulting in a 26.9% decline in total colonoscopies performed in 2020. The number of patients diagnosed by colonoscopy with CRC and advanced adenoma declined by 8.7% and 26.9%, respectively, in 2020 vs 2019., Conclusions: The pandemic led to fewer FIT screenings and colonoscopies in 2020 vs 2019; however, after the lifting of shelter-in-place orders, FIT screenings exceeded, and colonoscopy volumes nearly reached numbers from those same months in 2019. Overall, there was an 8.7% reduction in CRC cases diagnosed by colonoscopy in 2020. These data may help inform the development of strategies for CRC screening and diagnostic testing during future national emergencies., (Copyright © 2022 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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7. Gastroenterology 2016-2022: The End of a Road But Continuation of a Journey.
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Peek RM, Corley DA, Brounstein LM, Flecha L, and Simpson BA
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- Gastrointestinal Tract, Humans, Gastroenterology
- Published
- 2022
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8. Rising Early-onset Colorectal Cancer Incidence Is Not an Artifact of Increased Screening Colonoscopy Use in a Large, Diverse Healthcare System.
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Lee JK, Merchant SA, Jensen CD, Murphy CC, Udaltsova N, and Corley DA
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- Adolescent, Adult, Age of Onset, Artifacts, California epidemiology, Female, Humans, Incidence, Male, Middle Aged, Predictive Value of Tests, Reproducibility of Results, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Young Adult, Colonoscopy, Colorectal Neoplasms epidemiology, Colorectal Neoplasms pathology, Early Detection of Cancer
- Published
- 2022
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9. Advancing Diversity, Equity, and Inclusion in Scientific Publishing.
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Doubeni CA, Corley DA, and Peek RM Jr
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- Culturally Competent Care, Female, Gender Equity, Health Status Disparities, Healthcare Disparities ethnology, Humans, Male, Race Factors, Racism, Sexism, Biomedical Research, Cultural Diversity, Gastroenterology, Peer Review, Research, Periodicals as Topic, Prejudice
- Published
- 2022
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10. The Learning Health System: The Tools Are Here-Why Aren't We Moving Forward?
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Corley DA and Kilbourne A
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- Attitude of Health Personnel, Clinical Competence standards, Clinical Decision-Making, Diffusion of Innovation, Evidence-Based Medicine standards, Humans, Patient Safety standards, Professional Practice Gaps standards, Quality Assurance, Health Care standards, Quality Improvement standards, Quality Indicators, Health Care standards, Guideline Adherence standards, Learning Health System standards, Practice Guidelines as Topic standards, Practice Patterns, Physicians' standards
- Published
- 2021
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11. COVID-19: Guidance for What Clinicians and Scientists Should Do and When.
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Corley DA and Peek RM Jr
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- Humans, Physicians, COVID-19 epidemiology, Gastroenterology, Practice Guidelines as Topic, SARS-CoV-2
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- 2021
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12. Paradigm-Shifting Research in Gastroenterology, Hepatology, and Nutrition: A Top 20 List of Articles Published in 2020.
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Corley DA, Peek RM Jr, and Simpson BA
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- Gastroenterology methods, Humans, Gastroenterology trends, Publishing trends
- Published
- 2021
- Full Text
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13. Cancer Screening During the Coronavirus Disease-2019 Pandemic: A Perspective From the National Cancer Institute's PROSPR Consortium.
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Corley DA, Sedki M, Ritzwoller DP, Greenlee RT, Neslund-Dudas C, Rendle KA, Honda SA, Schottinger JE, Udaltsova N, Vachani A, Kobrin S, Li CI, and Haas JS
- Subjects
- Early Detection of Cancer economics, Health Status Disparities, Humans, National Cancer Institute (U.S.), Occult Blood, United States, COVID-19 epidemiology, Early Detection of Cancer statistics & numerical data, SARS-CoV-2
- Published
- 2021
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14. Influence of Telemedicine-first Intervention on Patient Visit Choice, Postvisit Care, and Patient Satisfaction in Gastroenterology.
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Munroe CA, Lin TY, Rouillard S, Fox J, Lee JK, and Corley DA
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- Adult, Aftercare psychology, Aftercare statistics & numerical data, Aged, Choice Behavior, Cross-Over Studies, Female, Gastroenterology statistics & numerical data, Humans, Male, Middle Aged, Patient Acceptance of Health Care psychology, Gastroenterology methods, Patient Acceptance of Health Care statistics & numerical data, Patient Satisfaction statistics & numerical data, Telemedicine statistics & numerical data
- Published
- 2021
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15. COVID-19 and Long-term Planning for Procedure-based Specialties During Extended Mitigation and Suppression Strategies.
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Rouillard S, Liu VX, and Corley DA
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- COVID-19 transmission, Humans, Pandemics, COVID-19 epidemiology, Disease Transmission, Infectious prevention & control, Guidelines as Topic, Health Planning organization & administration, Infection Control standards, SARS-CoV-2, Telemedicine organization & administration
- Published
- 2021
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16. Sex-Specific Genetic Associations for Barrett's Esophagus and Esophageal Adenocarcinoma.
- Author
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Dong J, Maj C, Tsavachidis S, Ostrom QT, Gharahkhani P, Anderson LA, Wu AH, Ye W, Bernstein L, Borisov O, Schröder J, Chow WH, Gammon MD, Liu G, Caldas C, Pharoah PD, Risch HA, May A, Gerges C, Anders M, Venerito M, Schmidt T, Izbicki JR, Hölscher AH, Schumacher B, Vashist Y, Neuhaus H, Rösch T, Knapp M, Krawitz P, Böhmer A, Iyer PG, Reid BJ, Lagergren J, Shaheen NJ, Corley DA, Gockel I, Fitzgerald RC, Cook MB, Whiteman DC, Vaughan TL, Schumacher J, and Thrift AP
- Subjects
- Adenocarcinoma epidemiology, Barrett Esophagus epidemiology, Case-Control Studies, Esophageal Neoplasms epidemiology, Eye Proteins genetics, Female, Gastroesophageal Reflux epidemiology, Gastroesophageal Reflux genetics, Genetic Loci, Genome-Wide Association Study, Humans, Male, Obesity epidemiology, Obesity genetics, Polymorphism, Single Nucleotide, RNA-Binding Proteins genetics, Risk Assessment, Risk Factors, Serine Endopeptidases genetics, Sex Factors, Adenocarcinoma genetics, Barrett Esophagus genetics, Biomarkers, Tumor genetics, Esophageal Neoplasms genetics, Genetic Predisposition to Disease
- Abstract
Background & Aims: Esophageal adenocarcinoma (EA) and its premalignant lesion, Barrett's esophagus (BE), are characterized by a strong and yet unexplained male predominance (with a male-to-female ratio in EA incidence of up to 6:1). Genome-wide association studies (GWAS) have identified more than 20 susceptibility loci for these conditions. However, potential sex differences in genetic associations with BE/EA remain largely unexplored., Methods: Given strong genetic overlap, BE and EA cases were combined into a single case group for analysis. These were compared with population-based controls. We performed sex-specific GWAS of BE/EA in 3 separate studies and then used fixed-effects meta-analysis to provide summary estimates for >9 million variants for male and female individuals. A series of downstream analyses were conducted separately in male and female individuals to identify genes associated with BE/EA and the genetic correlations between BE/EA and other traits., Results: We included 6758 male BE/EA cases, 7489 male controls, 1670 female BE/EA cases, and 6174 female controls. After Bonferroni correction, our meta-analysis of sex-specific GWAS identified 1 variant at chromosome 6q11.1 (rs112894788, KHDRBS2-MTRNR2L9, P
BONF = .039) that was statistically significantly associated with BE/EA risk in male individuals only, and 1 variant at chromosome 8p23.1 (rs13259457, PRSS55-RP1L1, PBONF = 0.057) associated, at borderline significance, with BE/EA risk in female individuals only. We also observed strong genetic correlations of BE/EA with gastroesophageal reflux disease in male individuals and obesity in female individuals., Conclusions: The identified novel sex-specific variants associated with BE/EA could improve the understanding of the genetic architecture of the disease and the reasons for the male predominance., (Copyright © 2020 AGA Institute. All rights reserved.)- Published
- 2020
- Full Text
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17. Early Screening of African Americans (45-50 Years Old) in a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program.
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Levin TR, Jensen CD, Chawla NM, Sakoda LC, Lee JK, Zhao WK, Landau MA, Herm A, Eby E, Quesenberry CP, and Corley DA
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- Age Factors, California epidemiology, Colonoscopy, Colorectal Neoplasms chemistry, Colorectal Neoplasms ethnology, Colorectal Neoplasms pathology, Female, Humans, Male, Middle Aged, Pilot Projects, Predictive Value of Tests, Prospective Studies, Race Factors, Risk Assessment, Risk Factors, Black or African American, Biomarkers, Tumor analysis, Colorectal Neoplasms diagnosis, Early Detection of Cancer, Feces chemistry, Immunologic Tests, Proto-Oncogene Proteins c-kit analysis
- Abstract
Background & Aims: Some guidelines recommend starting colorectal cancer (CRC) screening before age 50 years for African Americans, but there are few data on screening uptake and yield in this population., Methods: We performed a prospective study of fecal immunochemical test (FIT) screening among African American members of the Kaiser Permanente Northern California health plan. We compared data from African American members screened when they were 45-50 years old (early screening group) in 2018 with data from previously unscreened African American, white, Hispanic, and Asian/Pacific Islander health plan members who were 51-56 years old. Screening outreach was performed with mailed FIT kits. Logistic regression models, adjusted for sex, were used to evaluate differences among groups in screening uptake, colonoscopy follow-up of abnormal test results, and test yield., Results: Among 10,232 African Americans in the early screening group who were mailed a FIT, screening was completed by 33.1%. Among the 4% with positive test results, 85.3% completed a follow-up colonoscopy: 57.8% had any adenoma, 33.6% had an advanced adenoma (adenoma with advanced histology or polyp ≥10 mm), and 2.6% were diagnosed with CRC. African Americans in the early screening group were modestly more likely to have completed screening than previously unscreened African Americans, whites, and Hispanics 51-56 years old. The groups did not differ significantly in positive results from the FIT (range, 3.8%-4.6%) and more than 74% received a follow-up colonoscopy after a positive test result. The test yields for any adenoma (range, 56.7%-70.7%), advanced adenoma (range, 20.0%-33.6%), and CRC (range, 0%-7.1%) were similar., Conclusions: Proportions of African Americans who participated in early (aged 45-50 years) FIT screening and test yield were comparable to those of previously unscreened African Americans, whites, Hispanics, and Asian/Pacific Islanders who were 51-56 years old., (Copyright © 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
- Full Text
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18. Increased Risk of Colorectal Cancer in Individuals With a History of Serrated Polyps.
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Li D, Liu L, Fevrier HB, Alexeeff SE, Doherty AR, Raju M, Amsden LB, Lee JK, Levin TR, Corley DA, and Herrinton LJ
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- Aged, Aged, 80 and over, Colon diagnostic imaging, Colon pathology, Colonic Polyps diagnosis, Colonic Polyps pathology, Colonoscopy standards, Colorectal Neoplasms pathology, Early Detection of Cancer standards, Female, Follow-Up Studies, Humans, Incidence, Intestinal Mucosa diagnostic imaging, Intestinal Mucosa pathology, Male, Medical History Taking statistics & numerical data, Middle Aged, Practice Guidelines as Topic, Precancerous Conditions diagnosis, Precancerous Conditions pathology, Retrospective Studies, Risk Assessment statistics & numerical data, Risk Factors, Time Factors, United States epidemiology, Colonic Polyps epidemiology, Colonoscopy statistics & numerical data, Colorectal Neoplasms epidemiology, Precancerous Conditions epidemiology
- Abstract
Background and Aims: Serrated polyp (SPs) are precursors to 20% to 30% of cases of colorectal tumors, but patients' long-term risk after removal of SPs is poorly understood. We investigated the risk of colorectal cancer (CRC) in individuals with a history of SPs., Methods: We performed a retrospective cohort study of Kaiser Permanente Northern California members who underwent colonoscopy from 2006 through 2016. Study participants were categorized based on the size and location of SPs. We used Cox proportional hazards modeling to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the association of CRC diagnosed more than 1 year after colonoscopy, with polyp type vs no polyp after adjustment for year of colonoscopy, age, sex, race/ethnicity, and smoking history., Results: The study included 233,393 individuals, of whom 445 developed incident CRC. At 10 years, the cumulative incidence rates of CRC for individuals with no polyp, proximal small SPs, proximal large SPs, and distal SPs were 4.7 (95% CI, 4.0-5.6), 14.8 (95% CI, 9.0-24.3), 30.2 (95% CI, 13.2-68.4), and 5.9 (95% CI, 3.6-9.5) per 1000 persons, respectively. In patients with SPs, risk of CRC was not increased until 3 years or more after the first colonoscopy (HR for small proximal SPs 2.6; 95% CI, 1.7-3.9 and HR for large proximal SPs 8.0; 95% CI, 3.6-16.1). The presence of synchronous adenomas increased the risk for CRC (HR for proximal SPs with synchronous adenomas 4.0; 95% CI, 3.0-5.5 and HR for distal SPs with synchronous adenomas 2.4; 95% CI, 1.7-3.4)., Conclusions: In a retrospective analysis of a large cohort of individuals examined by colonoscopy, we found that risk of incident CRC increased in individuals with proximal SPs (large SPs in particular) 3 years or more after the colonoscopy. These findings support guidelines that recommend surveillance colonoscopy for individuals with SPs., (Copyright © 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
19. COVID-19: What Should Clinicians and Scientists Do and When?
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Corley DA and Peek RM
- Subjects
- Biomedical Research, COVID-19, Communicable Disease Control methods, Congresses as Topic, Coronavirus Infections diagnosis, Coronavirus Infections epidemiology, Coronavirus Infections transmission, Global Burden of Disease, Humans, Mass Screening methods, Mass Screening organization & administration, Pneumonia, Viral diagnosis, Pneumonia, Viral epidemiology, Pneumonia, Viral transmission, SARS-CoV-2, Betacoronavirus pathogenicity, Communicable Disease Control organization & administration, Coronavirus Infections prevention & control, Health Personnel organization & administration, Pandemics prevention & control, Pneumonia, Viral prevention & control, Research Personnel organization & administration
- Published
- 2020
- Full Text
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20. Cumulative Burden of Colorectal Cancer-Associated Genetic Variants Is More Strongly Associated With Early-Onset vs Late-Onset Cancer.
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Archambault AN, Su YR, Jeon J, Thomas M, Lin Y, Conti DV, Win AK, Sakoda LC, Lansdorp-Vogelaar I, Peterse EFP, Zauber AG, Duggan D, Holowatyj AN, Huyghe JR, Brenner H, Cotterchio M, Bézieau S, Schmit SL, Edlund CK, Southey MC, MacInnis RJ, Campbell PT, Chang-Claude J, Slattery ML, Chan AT, Joshi AD, Song M, Cao Y, Woods MO, White E, Weinstein SJ, Ulrich CM, Hoffmeister M, Bien SA, Harrison TA, Hampe J, Li CI, Schafmayer C, Offit K, Pharoah PD, Moreno V, Lindblom A, Wolk A, Wu AH, Li L, Gunter MJ, Gsur A, Keku TO, Pearlman R, Bishop DT, Castellví-Bel S, Moreira L, Vodicka P, Kampman E, Giles GG, Albanes D, Baron JA, Berndt SI, Brezina S, Buch S, Buchanan DD, Trichopoulou A, Severi G, Chirlaque MD, Sánchez MJ, Palli D, Kühn T, Murphy N, Cross AJ, Burnett-Hartman AN, Chanock SJ, de la Chapelle A, Easton DF, Elliott F, English DR, Feskens EJM, FitzGerald LM, Goodman PJ, Hopper JL, Hudson TJ, Hunter DJ, Jacobs EJ, Joshu CE, Küry S, Markowitz SD, Milne RL, Platz EA, Rennert G, Rennert HS, Schumacher FR, Sandler RS, Seminara D, Tangen CM, Thibodeau SN, Toland AE, van Duijnhoven FJB, Visvanathan K, Vodickova L, Potter JD, Männistö S, Weigl K, Figueiredo J, Martín V, Larsson SC, Parfrey PS, Huang WY, Lenz HJ, Castelao JE, Gago-Dominguez M, Muñoz-Garzón V, Mancao C, Haiman CA, Wilkens LR, Siegel E, Barry E, Younghusband B, Van Guelpen B, Harlid S, Zeleniuch-Jacquotte A, Liang PS, Du M, Casey G, Lindor NM, Le Marchand L, Gallinger SJ, Jenkins MA, Newcomb PA, Gruber SB, Schoen RE, Hampel H, Corley DA, Hsu L, Peters U, and Hayes RB
- Subjects
- Age of Onset, Case-Control Studies, Cohort Studies, DNA Mutational Analysis, Datasets as Topic, Female, Genome-Wide Association Study, Genotyping Techniques, Humans, Life Style, Male, Medical History Taking, Middle Aged, Mutation Rate, Polymorphism, Single Nucleotide, Risk Factors, Whole Genome Sequencing, Colorectal Neoplasms genetics, Genetic Predisposition to Disease
- Abstract
Background & Aims: Early-onset colorectal cancer (CRC, in persons younger than 50 years old) is increasing in incidence; yet, in the absence of a family history of CRC, this population lacks harmonized recommendations for prevention. We aimed to determine whether a polygenic risk score (PRS) developed from 95 CRC-associated common genetic risk variants was associated with risk for early-onset CRC., Methods: We studied risk for CRC associated with a weighted PRS in 12,197 participants younger than 50 years old vs 95,865 participants 50 years or older. PRS was calculated based on single nucleotide polymorphisms associated with CRC in a large-scale genome-wide association study as of January 2019. Participants were pooled from 3 large consortia that provided clinical and genotyping data: the Colon Cancer Family Registry, the Colorectal Transdisciplinary Study, and the Genetics and Epidemiology of Colorectal Cancer Consortium and were all of genetically defined European descent. Findings were replicated in an independent cohort of 72,573 participants., Results: Overall associations with CRC per standard deviation of PRS were significant for early-onset cancer, and were stronger compared with late-onset cancer (P for interaction = .01); when we compared the highest PRS quartile with the lowest, risk increased 3.7-fold for early-onset CRC (95% CI 3.28-4.24) vs 2.9-fold for late-onset CRC (95% CI 2.80-3.04). This association was strongest for participants without a first-degree family history of CRC (P for interaction = 5.61 × 10
-5 ). When we compared the highest with the lowest quartiles in this group, risk increased 4.3-fold for early-onset CRC (95% CI 3.61-5.01) vs 2.9-fold for late-onset CRC (95% CI 2.70-3.00). Sensitivity analyses were consistent with these findings., Conclusions: In an analysis of associations with CRC per standard deviation of PRS, we found the cumulative burden of CRC-associated common genetic variants to associate with early-onset cancer, and to be more strongly associated with early-onset than late-onset cancer, particularly in the absence of CRC family history. Analyses of PRS, along with environmental and lifestyle risk factors, might identify younger individuals who would benefit from preventive measures., (Copyright © 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.)- Published
- 2020
- Full Text
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21. Promises and Potential Pitfalls of Shared Decision Making in Cancer Screening.
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Haug U, Senore C, and Corley DA
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- Humans, Mass Screening psychology, Neoplasms mortality, Neoplasms prevention & control, Time Factors, Decision Making, Shared, Early Detection of Cancer psychology, Mass Screening organization & administration, Neoplasms diagnosis, Patient Participation psychology
- Published
- 2020
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22. Long-term Risk of Colorectal Cancer and Related Death After Adenoma Removal in a Large, Community-based Population.
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Lee JK, Jensen CD, Levin TR, Doubeni CA, Zauber AG, Chubak J, Kamineni AS, Schottinger JE, Ghai NR, Udaltsova N, Zhao WK, Fireman BH, Quesenberry CP, Orav EJ, Skinner CS, Halm EA, and Corley DA
- Subjects
- Adenoma pathology, Aged, California epidemiology, Colonoscopy statistics & numerical data, Colorectal Neoplasms diagnostic imaging, Colorectal Neoplasms pathology, Colorectal Neoplasms prevention & control, Early Detection of Cancer statistics & numerical data, Evidence-Based Medicine statistics & numerical data, Female, Follow-Up Studies, Humans, Male, Medical History Taking, Middle Aged, Practice Guidelines as Topic, Proportional Hazards Models, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Adenoma surgery, Colonoscopy standards, Colorectal Neoplasms epidemiology, Early Detection of Cancer standards, Evidence-Based Medicine standards
- Abstract
Background & Aims: The long-term risks of colorectal cancer (CRC) and CRC-related death following adenoma removal are uncertain. Data are needed to inform evidence-based surveillance guidelines, which vary in follow-up recommendations for some polyp types. Using data from a large, community-based integrated health care setting, we examined the risks of CRC and related death by baseline colonoscopy adenoma findings., Methods: Participants at 21 medical centers underwent baseline colonoscopies from 2004 through 2010; findings were categorized as no-adenoma, low-risk adenoma, or high-risk adenoma. Participants were followed until the earliest of CRC diagnosis, death, health plan disenrollment, or December 31, 2017. Risks of CRC and related deaths among the high- and low-risk adenoma groups were compared with the no-adenoma group using Cox regression adjusting for confounders., Results: Among 186,046 patients, 64,422 met eligibility criteria (54.3% female; mean age, 61.6 ± 7.1 years; median follow-up time, 8.1 years from the baseline colonoscopy). Compared with the no-adenoma group (45,881 patients), the high-risk adenoma group (7563 patients) had a higher risk of CRC (hazard ratio [HR] 2.61; 95% confidence interval [CI] 1.87-3.63) and related death (HR 3.94; 95% CI 1.90-6.56), whereas the low-risk adenoma group (10,978 patients) did not have a significant increase in risk of CRC (HR 1.29; 95% CI 0.89-1.88) or related death (HR 0.65; 95% CI 0.19-2.18)., Conclusions: With up to 14 years of follow-up, high-risk adenomas were associated with an increased risk of CRC and related death, supporting early colonoscopy surveillance. Low-risk adenomas were not associated with a significantly increased risk of CRC or related deaths. These results can inform current surveillance guidelines for high- and low-risk adenomas., (Copyright © 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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23. Effect of Sex, Age, and Positivity Threshold on Fecal Immunochemical Test Accuracy: A Systematic Review and Meta-analysis.
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Selby K, Levine EH, Doan C, Gies A, Brenner H, Quesenberry C, Lee JK, and Corley DA
- Subjects
- Age Factors, Colonoscopy, Early Detection of Cancer methods, Hemoglobins analysis, Humans, Mass Screening methods, Reference Standards, Sensitivity and Specificity, Sex Factors, Adenoma diagnosis, Colorectal Neoplasms diagnosis, Early Detection of Cancer standards, Mass Screening standards, Occult Blood
- Abstract
Background & Aims: Quantitative fecal immunochemical tests (FITs) for hemoglobin are commonly used for colorectal cancer (CRC) screening. We aimed to quantify the change in CRC and advanced adenoma detection and number of positive test results at different positivity thresholds and by sex and age., Methods: We searched MEDLINE and EMBASE, selecting articles of FIT for CRC detection in asymptomatic adults undergoing screening. We calculated sensitivity and specificity, as well as detected number of cancers, advanced adenomas, and positive test results at positivity thresholds ≤10 μg hemoglobin/g feces, 10 to ≤20 μg/g, 20 to ≤30 μg/g, and >30 μg/g. We also analyzed results from stratified by patient sex, age, and reference standard., Results: Our meta-analysis comprised 46 studies with 2.4 million participants and 6478 detected cancers. Sensitivity for detection of CRC increased from 69% (95% confidence interval [CI], 63%-75%) at thresholds >10 μg/g and ≤20 μg/g to 80% (95% CI, 76%-83%) at thresholds ≤10 μg/g. At these threshold values, sensitivity for detection of advanced adenomas increased from 21% (95% CI, 18%-25%) to 31% (95% CI, 27%-35%), whereas specificity decreased from 94% (95% CI, 93%-96%) to 91% (95% CI, 89%-93%). In 3 studies stratified by sex, sensitivity of CRC detection was 77% in men (95% CI, 75%-79%) and 81% in women (95% CI, 60%-100%) (P = .68). In 3 studies stratified by age groups, sensitivity of CRC detection was 85% for ages 50-59 years (95% CI, 71%-99%) and 73% for ages 60-69 years (95% CI, 71%-75%) (P = .10). All studies with colonoscopy follow-up had similar sensitivity levels for detection of CRC to studies that analyzed 2-year registry follow-up data (74%; 95% CI, 68%-78% vs 75%; 95% CI, 73%-77%)., Conclusions: In a meta-analysis of studies that analyzed detection of CRC and advanced adenomas at different FIT positivity thresholds, we found the sensitivity and specificity of detection to vary with positive cutoff value. It might be possible to decrease positive threshold values for centers with sufficient follow-up colonoscopy resources. More research is needed to precisely establish FIT thresholds for each sex and age subgroup., Protocol: PROSPERO CRD42017068760., (Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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24. Safety and Complications of Long-Term Proton Pump Inhibitor Therapy: Getting Closer to the Truth.
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Corley DA
- Subjects
- Humans, Proton Pumps, Rivaroxaban, Aspirin, Proton Pump Inhibitors
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- 2019
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25. Will a Proton Pump Inhibitor and an Aspirin Keep the Doctor Away for Patients With Barrett's Esophagus?
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Fitzgerald RC and Corley DA
- Subjects
- Aspirin, Esomeprazole, Humans, Proton Pump Inhibitors, Barrett Esophagus, Esophageal Neoplasms
- Published
- 2019
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26. Modifiable Failures in the Colorectal Cancer Screening Process and Their Association With Risk of Death.
- Author
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Doubeni CA, Fedewa SA, Levin TR, Jensen CD, Saia C, Zebrowski AM, Quinn VP, Rendle KA, Zauber AG, Becerra-Culqui TA, Mehta SJ, Fletcher RH, Schottinger J, and Corley DA
- Subjects
- Adenocarcinoma prevention & control, Aged, Aged, 80 and over, California epidemiology, Cause of Death, Colorectal Neoplasms prevention & control, Early Detection of Cancer adverse effects, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Predictive Value of Tests, Protective Factors, Reproducibility of Results, Retrospective Studies, Risk Factors, Time Factors, Adenocarcinoma diagnosis, Adenocarcinoma mortality, Colorectal Neoplasms diagnosis, Colorectal Neoplasms mortality, Early Detection of Cancer mortality
- Abstract
Background & Aims: Colorectal cancer (CRC) deaths occur when patients do not receive screening or have inadequate follow-up of abnormal results or when the screening test fails. We have few data on the contribution of each to CRC-associated deaths or factors associated with these events., Methods: We performed a retrospective cohort study of patients in the Kaiser Permanente Northern and Southern California systems (55-90 years old) who died of CRC from 2006 through 2012 and had ≥5 years of enrollment before diagnosis. We compared data from patients with those from a matched cohort of cancer-free patients in the same system. Receipt, results, indications, and follow-up of CRC tests in the 10-year period before diagnosis were obtained from electronic databases and chart audits., Results: Of 1750 CRC deaths, 75.9% (n = 1328) occurred in patients who were not up to date in screening and 24.1% (n = 422) occurred in patients who were up to date. Failure to screen was associated with fewer visits to primary care physicians. Of 3486 cancer-free patients, 44.6% were up to date in their screening. Patients who were up to date in their screening had a lower risk of CRC death (odds ratio, 0.38; 95% confidence interval, 0.33-0.44). Failure to screen, or failure to screen at appropriate intervals, occurred in a 67.8% of patients who died of CRC vs 53.2% of cancer-free patients; failure to follow-up on abnormal results occurred in 8.1% of patients who died of CRC vs 2.2% of cancer-free patients. CRC death was associated with higher odds of failure to screen or failure to screen at appropriate intervals (odds ratio, 2.40; 95% confidence interval, 2.07-2.77) and failure to follow-up on abnormal results (odds ratio, 7.26; 95% confidence interval, 5.26-10.03)., Conclusions: Being up to date on screening substantially decreases the risk of CRC death. In 2 health care systems with high rates of screening, most people who died of CRC had failures in the screening process that could be rectified, such as failure to follow-up on abnormal findings; these significantly increased the risk for CRC death., (Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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27. Gastroenterology's Improvements and New Features.
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Corley DA, Peek RM Jr, Lowe C, Brounstein L, and Landis E
- Published
- 2018
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28. Effects of Organized Colorectal Cancer Screening on Cancer Incidence and Mortality in a Large Community-Based Population.
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Levin TR, Corley DA, Jensen CD, Schottinger JE, Quinn VP, Zauber AG, Lee JK, Zhao WK, Udaltsova N, Ghai NR, Lee AT, Quesenberry CP, Fireman BH, and Doubeni CA
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- Aged, Colonoscopy, Colorectal Neoplasms epidemiology, Colorectal Neoplasms mortality, Female, Humans, Incidence, Male, Middle Aged, Occult Blood, Colorectal Neoplasms diagnosis, Early Detection of Cancer
- Abstract
Background & Aims: Little information is available on the effectiveness of organized colorectal cancer (CRC) screening on screening uptake, incidence, and mortality in community-based populations., Methods: We contrasted screening rates, age-adjusted annual CRC incidence, and incidence-based mortality rates before (baseline year 2000) and after (through 2015) implementation of organized screening outreach, from 2007 through 2008 (primarily annual fecal immunochemical testing and colonoscopy), in a large community-based population. Among screening-eligible individuals 51-75 years old, we calculated annual up-to-date status for cancer screening (by fecal test, sigmoidoscopy, or colonoscopy), CRC incidence, cancer stage distributions, and incidence-based mortality., Results: Initiation of organized CRC screening significantly increased the up-to-date status of screening, from 38.9% in 2000 to 82.7% in 2015 (P < .01). Higher rates of screening were associated with a 25.5% reduction in annual CRC incidence between 2000 and 2015, from 95.8 to 71.4 cases/100,000 (P < .01), and a 52.4% reduction in cancer mortality, from 30.9 to 14.7 deaths/100,000 (P < .01). Increased screening was initially associated with increased CRC incidence, due largely to greater detection of early-stage cancers, followed by decreases in cancer incidence. Advanced-stage CRC incidence rates decreased 36.2%, from 45.9 to 29.3 cases/100,000 (P < .01), and early-stage CRC incidence rates decreased 14.5%, from 48.2 to 41.2 cases/100,000 (P < .04)., Conclusions: Implementing an organized CRC screening program in a large community-based population rapidly increased screening participation to the ≥80% target set by national organizations. Screening rates were sustainable and associated with substantial decreases in CRC incidence and mortality within short time intervals, consistent with early detection and cancer prevention., (Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
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29. When Should Guidelines Change? A Clarion Call for Evidence Regarding the Benefits and Risks of Screening for Colorectal Cancer at Earlier Ages.
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Corley DA and Peek RM Jr
- Subjects
- Age Factors, Aged, Aged, 80 and over, Clinical Decision-Making, Colorectal Neoplasms epidemiology, Colorectal Neoplasms therapy, Evidence-Based Medicine standards, Humans, Incidence, Middle Aged, Predictive Value of Tests, Prognosis, Risk Assessment, Risk Factors, United States epidemiology, Colorectal Neoplasms diagnosis, Early Detection of Cancer standards, Gastroenterology standards, Practice Guidelines as Topic standards
- Published
- 2018
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30. Overdiagnosis in Colorectal Cancer Screening: Time to Acknowledge a Blind Spot.
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Kalager M, Wieszczy P, Lansdorp-Vogelaar I, Corley DA, Bretthauer M, and Kaminski MF
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- Humans, Colorectal Neoplasms diagnosis, Early Detection of Cancer adverse effects, Medical Overuse trends
- Published
- 2018
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31. World Endoscopy Organization Consensus Statements on Post-Colonoscopy and Post-Imaging Colorectal Cancer.
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Rutter MD, Beintaris I, Valori R, Chiu HM, Corley DA, Cuatrecasas M, Dekker E, Forsberg A, Gore-Booth J, Haug U, Kaminski MF, Matsuda T, Meijer GA, Morris E, Plumb AA, Rabeneck L, Robertson DJ, Schoen RE, Singh H, Tinmouth J, Young GP, and Sanduleanu S
- Subjects
- Colon diagnostic imaging, Colonoscopy methods, Consensus, Early Detection of Cancer methods, Humans, Risk Factors, Time Factors, Colonoscopy standards, Colorectal Neoplasms diagnosis, Early Detection of Cancer standards, Practice Guidelines as Topic standards
- Abstract
Background & Aims: Colonoscopy examination does not always detect colorectal cancer (CRC)- some patients develop CRC after negative findings from an examination. When this occurs before the next recommended examination, it is called interval cancer. From a colonoscopy quality assurance perspective, that term is too restrictive, so the term post-colonoscopy colorectal cancer (PCCRC) was created in 2010. However, PCCRC definitions and methods for calculating rates vary among studies, making it impossible to compare results. We aimed to standardize the terminology, identification, analysis, and reporting of PCCRCs and CRCs detected after other whole-colon imaging evaluations (post-imaging colorectal cancers [PICRCs])., Methods: A 20-member international team of gastroenterologists, pathologists, and epidemiologists; a radiologist; and a non-medical professional met to formulate a series of recommendations, standardize definitions and categories (to align with interval cancer terminology), develop an algorithm to determine most-plausible etiologies, and develop standardized methodology to calculate rates of PCCRC and PICRC. The team followed the Appraisal of Guidelines for Research and Evaluation II tool. A literature review provided 401 articles to support proposed statements; evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. The statements were voted on anonymously by team members, using a modified Delphi approach., Results: The team produced 21 statements that provide comprehensive guidance on PCCRCs and PICRCs. The statements present standardized definitions and terms, as well as methods for qualitative review, determination of etiology, calculation of PCCRC rates, and non-colonoscopic imaging of the colon., Conclusions: A 20-member international team has provided standardized methods for analysis of etiologies of PCCRCs and PICRCs and defines its use as a quality indicator. The team provides recommendations for clinicians, organizations, researchers, policy makers, and patients., (Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
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32. Determining Risk of Barrett's Esophagus and Esophageal Adenocarcinoma Based on Epidemiologic Factors and Genetic Variants.
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Dong J, Buas MF, Gharahkhani P, Kendall BJ, Onstad L, Zhao S, Anderson LA, Wu AH, Ye W, Bird NC, Bernstein L, Chow WH, Gammon MD, Liu G, Caldas C, Pharoah PD, Risch HA, Iyer PG, Reid BJ, Hardie LJ, Lagergren J, Shaheen NJ, Corley DA, Fitzgerald RC, Whiteman DC, Vaughan TL, and Thrift AP
- Subjects
- Adenocarcinoma diagnosis, Area Under Curve, Australia epidemiology, Barrett Esophagus diagnosis, Case-Control Studies, Databases, Factual, Esophageal Neoplasms diagnosis, Europe epidemiology, Female, Gene-Environment Interaction, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Life Style, Logistic Models, Male, Middle Aged, Molecular Epidemiology, Multifactorial Inheritance, North America epidemiology, Odds Ratio, Phenotype, Predictive Value of Tests, ROC Curve, Risk Assessment, Risk Factors, Adenocarcinoma epidemiology, Adenocarcinoma genetics, Barrett Esophagus epidemiology, Barrett Esophagus genetics, Decision Support Techniques, Esophageal Neoplasms epidemiology, Esophageal Neoplasms genetics, Models, Genetic, Polymorphism, Single Nucleotide
- Abstract
Background & Aims: We developed comprehensive models to determine risk of Barrett's esophagus (BE) or esophageal adenocarcinoma (EAC) based on genetic and non-genetic factors., Methods: We used pooled data from 3288 patients with BE, 2511 patients with EAC, and 2177 individuals without either (controls) from participants in the international Barrett's and EAC consortium as well as the United Kingdom's BE gene study and stomach and esophageal cancer study. We collected data on 23 genetic variants associated with risk for BE or EAC, and constructed a polygenic risk score (PRS) for cases and controls by summing the risk allele counts for the variants weighted by their natural log-transformed effect estimates (odds ratios) extracted from genome-wide association studies. We also collected data on demographic and lifestyle factors (age, sex, smoking, body mass index, use of nonsteroidal anti-inflammatory drugs) and symptoms of gastroesophageal reflux disease (GERD). Risk models with various combinations of non-genetic factors and the PRS were compared for their accuracy in identifying patients with BE or EAC using the area under the receiver operating characteristic curve (AUC) analysis., Results: Individuals in the highest quartile of risk, based on genetic factors (PRS), had a 2-fold higher risk of BE (odds ratio, 2.22; 95% confidence interval, 1.89-2.60) or EAC (odds ratio, 2.46; 95% confidence interval, 2.07-2.92) than individual in the lowest quartile of risk based on PRS. Risk models developed based on only demographic or lifestyle factors or GERD symptoms identified patients with BE or EAC with AUC values ranging from 0.637 to 0.667. Combining data on demographic or lifestyle factors with data on GERD symptoms identified patients with BE with an AUC of 0.793 and patients with EAC with an AUC of 0.745. Including PRSs with these data only minimally increased the AUC values for BE (to 0.799) and EAC (to 0.754). Including the PRSs in the model developed based on non-genetic factors resulted in a net reclassification improvement for BE of 3.0% and for EAC of 5.6%., Conclusions: We used data from 3 large databases of patients from studies of BE or EAC to develop a risk prediction model based on genetic, clinical, and demographic/lifestyle factors. We identified a PRS that increases discrimination and net reclassification of individuals with vs without BE and EAC. However, the absolute magnitude of improvement is not sufficient to justify its clinical use., (Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
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33. The 75 th Diamond Anniversary of Gastroenterology: 1943-2018.
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Peek RM and Corley DA
- Subjects
- Anniversaries and Special Events, History, 20th Century, History, 21st Century, Gastroenterology history, Periodicals as Topic history, Societies, Medical history
- Published
- 2018
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34. Proton Pump Inhibitor and Histamine-2 Receptor Antagonist Use and Iron Deficiency.
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Lam JR, Schneider JL, Quesenberry CP, and Corley DA
- Subjects
- Adult, Aged, Aged, 80 and over, Case-Control Studies, Female, Histamine H2 Antagonists administration & dosage, Humans, Malabsorption Syndromes chemically induced, Male, Middle Aged, Proton Pump Inhibitors administration & dosage, Time Factors, Histamine H2 Antagonists adverse effects, Iron Deficiencies, Proton Pump Inhibitors adverse effects
- Abstract
Background & Aims: Proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) suppress gastric acid production, which can inhibit iron absorption. However, few data exist regarding whether these medications increase the risk of clinical iron deficiency., Methods: A community-based case-control study evaluated the association between acid-suppressing medication use and the subsequent risk of iron deficiency. It contrasted 77,046 patients with new iron deficiency diagnoses (January 1999-December 2013), with 389,314 controls. Medication exposures, outcomes, and potential confounders used electronic databases. We excluded patients with pre-existing risk factors for iron deficiency. Associations were estimated using conditional logistic regression., Results: Among cases, 2343 (3.0%) received a prior ≥2-year supply of PPIs and 1063 (1.4%) received H2RAs (without PPI use). Among controls, 3354 (0.9%) received a prior ≥2-year supply of PPIs and 2247 (0.6%) H2RAs. Both ≥2 years of PPIs (adjusted odds ratio, 2.49; 95% confidence interval, 2.35-2.64) and ≥2 years of H2RAs (odds ratio, 1.58; 95% CI, 1.46-1.71) were associated with an increased subsequent risk for iron deficiency. Among PPI users, the associations were stronger for higher daily doses (>1.5 vs <0.75 PPI pills/d; P value interaction = .004) and decreased after medication discontinuation (P-trend < .001). Some of the strongest associations were among persons taking >1.5 pills per day for at least 10 years (odds ratio, 4.27; 95% CI, 2.53-7.21). No similar strong associations were found for other commonly used prescription medications., Conclusions: Among patients without known risk factors for iron deficiency, gastric acid inhibitor use for ≥2 years was associated with an increased subsequent risk of iron deficiency. The risk increased with increasing potency of acid inhibition and decreased after medication discontinuation., (Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
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35. The Dawning of a New Editorial Board for Gastroenterology.
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Corley DA and Peek RM Jr
- Subjects
- Access to Information, Authorship, Editorial Policies, Goals, Humans, Information Dissemination, Journal Impact Factor, Peer Review, Research, Biomedical Research, Gastroenterology, Periodicals as Topic
- Published
- 2016
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36. Colorectal Cancer Health Disparities and the Role of US Law and Health Policy.
- Author
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Doubeni CA, Corley DA, and Zauber AG
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- Colorectal Neoplasms economics, Colorectal Neoplasms mortality, Colorectal Neoplasms prevention & control, Early Detection of Cancer economics, Early Detection of Cancer standards, Eligibility Determination, Guideline Adherence, Health Care Costs legislation & jurisprudence, Health Policy economics, Health Services Accessibility economics, Health Services Accessibility standards, Healthcare Disparities economics, Healthcare Disparities standards, Humans, Medicare Part B legislation & jurisprudence, Practice Guidelines as Topic, Predictive Value of Tests, Prognosis, United States epidemiology, Colonoscopy economics, Colonoscopy standards, Colorectal Neoplasms diagnosis, Early Detection of Cancer methods, Government Regulation, Health Policy legislation & jurisprudence, Health Services Accessibility legislation & jurisprudence, Healthcare Disparities legislation & jurisprudence
- Published
- 2016
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37. Population-representative incidence of drug-induced acute liver failure based on an analysis of an integrated health care system.
- Author
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Goldberg DS, Forde KA, Carbonari DM, Lewis JD, Leidl KB, Reddy KR, Haynes K, Roy J, Sha D, Marks AR, Schneider JL, Strom BL, Corley DA, and Lo Re V 3rd
- Subjects
- Adult, Aged, Aged, 80 and over, California epidemiology, Chemical and Drug Induced Liver Injury diagnosis, Chemical and Drug Induced Liver Injury therapy, Databases, Factual, Dietary Supplements adverse effects, Female, Humans, Incidence, Liver Failure, Acute diagnosis, Liver Failure, Acute therapy, Male, Middle Aged, Nonprescription Drugs adverse effects, Plant Preparations adverse effects, Prognosis, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Chemical and Drug Induced Liver Injury epidemiology, Delivery of Health Care, Integrated statistics & numerical data, Liver Failure, Acute epidemiology
- Abstract
Background & Aims: Medications are a major cause of acute liver failure (ALF) in the United States, but no population-based studies have evaluated the incidence of ALF from drug-induced liver injury. We aimed to determine the incidence and outcomes of drug-induced ALF in an integrated health care system that approximates a population-based cohort., Methods: We performed a retrospective cohort study using data from the Kaiser Permanente Northern California (KPNC) health care system between January 1, 2004, and December 31, 2010. We included all KPNC members age 18 years and older with 6 months or more of membership and hospitalization for potential ALF. The primary outcome was drug-induced ALF (defined as coagulopathy and hepatic encephalopathy without underlying chronic liver disease), determined by hepatologists who reviewed medical records of all KPNC members with inpatient diagnostic and laboratory criteria suggesting potential ALF., Results: Among 5,484,224 KPNC members between 2004 and 2010, 669 had inpatient diagnostic and laboratory criteria indicating potential ALF. After medical record review, 62 (9.3%) were categorized as having definite or possible ALF, and 32 (51.6%) had a drug-induced etiology (27 definite, 5 possible). Acetaminophen was implicated in 18 events (56.3%), dietary/herbal supplements in 6 events (18.8%), antimicrobials in 2 events (6.3%), and miscellaneous medications in 6 events (18.8%). One patient with acetaminophen-induced ALF died (5.6%; 0.06 events/1,000,000 person-years) compared with 3 patients with non-acetaminophen-induced ALF (21.4%; 0.18/1,000,000 person-years). Overall, 6 patients (18.8%) underwent liver transplantation, and 22 patients (68.8%) were discharged without transplantation. The incidence rates of any definite drug-induced ALF and acetaminophen-induced ALF were 1.61 events/1,000,000 person-years (95% confidence interval, 1.06-2.35) and 1.02 events/1,000,000 person-years (95% confidence interval, 0.59-1.63), respectively., Conclusions: Drug-induced ALF is uncommon, but over-the-counter products and dietary/herbal supplements are its most common causes., (Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
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38. Food, the immune system, and the gastrointestinal tract.
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Corley DA and Schuppan D
- Subjects
- Animals, Food Hypersensitivity immunology, Food Hypersensitivity physiopathology, Gastrointestinal Diseases immunology, Gastrointestinal Diseases microbiology, Gastrointestinal Diseases physiopathology, Gastrointestinal Tract immunology, Gastrointestinal Tract microbiology, Humans, Microbiota, Nutritional Status, Risk Factors, Diet adverse effects, Food Hypersensitivity therapy, Gastrointestinal Diseases diet therapy, Gastrointestinal Tract physiopathology, Immune System physiopathology
- Published
- 2015
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39. Diet and upper gastrointestinal malignancies.
- Author
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Abnet CC, Corley DA, Freedman ND, and Kamangar F
- Subjects
- Alcohol Drinking adverse effects, Animals, Antioxidants administration & dosage, Coffee adverse effects, Esophageal Neoplasms diagnosis, Esophageal Neoplasms epidemiology, Feeding Behavior, Food Handling, Fruit, Humans, Life Style, Meat adverse effects, Protective Factors, Risk Assessment, Risk Factors, Sodium Chloride, Dietary adverse effects, Stomach Neoplasms diagnosis, Stomach Neoplasms epidemiology, Tea adverse effects, Vegetables adverse effects, Vitamins administration & dosage, Anticarcinogenic Agents administration & dosage, Diet adverse effects, Esophageal Neoplasms prevention & control, Risk Reduction Behavior, Stomach Neoplasms prevention & control
- Abstract
Diet is believed to modulate cancer risk and this relationship has been widely studied in the gastrointestinal tract. Observational epidemiologic studies have provided most of the evidence about the effects of diet on cancer risk because clinical trials to determine nutritional exposures are often impossible, impractical, or unaffordable. Although a few foods or nutrients are thought to protect against specific types of cancer, it seems clear that the strength and even direction of dietary associations (increasing or decreasing risk) is organ-site- and even histology-specific, along the gastrointestinal tract. Although some hypotheses are supported by a substantial body of observational data (drinking hot maté [an infusion of the herb Ilex Paraguarensis] contributes to esophageal cancer), there are not much data to support others. We discuss some highly touted hypotheses and draw interim conclusions about what is known and what could be done to improve the level of evidence. The complex nature of diet and its associations can be productively investigated with disease-specific studies. However, public health recommendations for normal-risk individuals regarding diet and gastrointestinal cancer should probably emphasize the importance of eating for overall health rather than eating specific foods to reduce risk for specific cancers., (Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
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40. Polymorphisms near TBX5 and GDF7 are associated with increased risk for Barrett's esophagus.
- Author
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Palles C, Chegwidden L, Li X, Findlay JM, Farnham G, Castro Giner F, Peppelenbosch MP, Kovac M, Adams CL, Prenen H, Briggs S, Harrison R, Sanders S, MacDonald D, Haigh C, Tucker A, Love S, Nanji M, deCaestecker J, Ferry D, Rathbone B, Hapeshi J, Barr H, Moayyedi P, Watson P, Zietek B, Maroo N, Gay L, Underwood T, Boulter L, McMurtry H, Monk D, Patel P, Ragunath K, Al Dulaimi D, Murray I, Koss K, Veitch A, Trudgill N, Nwokolo C, Rembacken B, Atherfold P, Green E, Ang Y, Kuipers EJ, Chow W, Paterson S, Kadri S, Beales I, Grimley C, Mullins P, Beckett C, Farrant M, Dixon A, Kelly S, Johnson M, Wajed S, Dhar A, Sawyer E, Roylance R, Onstad L, Gammon MD, Corley DA, Shaheen NJ, Bird NC, Hardie LJ, Reid BJ, Ye W, Liu G, Romero Y, Bernstein L, Wu AH, Casson AG, Fitzgerald R, Whiteman DC, Risch HA, Levine DM, Vaughan TL, Verhaar AP, van den Brande J, Toxopeus EL, Spaander MC, Wijnhoven BP, van der Laan LJ, Krishnadath K, Wijmenga C, Trynka G, McManus R, Reynolds JV, O'Sullivan J, MacMathuna P, McGarrigle SA, Kelleher D, Vermeire S, Cleynen I, Bisschops R, Tomlinson I, and Jankowski J
- Subjects
- Barrett Esophagus etiology, Esophageal Neoplasms genetics, Genome-Wide Association Study, Humans, Risk, Barrett Esophagus genetics, Bone Morphogenetic Proteins genetics, Genetic Predisposition to Disease, Growth Differentiation Factors genetics, Polymorphism, Single Nucleotide, T-Box Domain Proteins genetics
- Abstract
Background & Aims: Barrett's esophagus (BE) increases the risk of esophageal adenocarcinoma (EAC). We found the risk to be BE has been associated with single nucleotide polymorphisms (SNPs) on chromosome 6p21 (within the HLA region) and on 16q23, where the closest protein-coding gene is FOXF1. Subsequently, the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON) identified risk loci for BE and esophageal adenocarcinoma near CRTC1 and BARX1, and within 100 kb of FOXP1. We aimed to identify further SNPs that increased BE risk and to validate previously reported associations., Methods: We performed a genome-wide association study (GWAS) to identify variants associated with BE and further analyzed promising variants identified by BEACON by genotyping 10,158 patients with BE and 21,062 controls., Results: We identified 2 SNPs not previously associated with BE: rs3072 (2p24.1; odds ratio [OR] = 1.14; 95% CI: 1.09-1.18; P = 1.8 × 10(-11)) and rs2701108 (12q24.21; OR = 0.90; 95% CI: 0.86-0.93; P = 7.5 × 10(-9)). The closest protein-coding genes were respectively GDF7 (rs3072), which encodes a ligand in the bone morphogenetic protein pathway, and TBX5 (rs2701108), which encodes a transcription factor that regulates esophageal and cardiac development. Our data also supported in BE cases 3 risk SNPs identified by BEACON (rs2687201, rs11789015, and rs10423674). Meta-analysis of all data identified another SNP associated with BE and esophageal adenocarcinoma: rs3784262, within ALDH1A2 (OR = 0.90; 95% CI: 0.87-0.93; P = 3.72 × 10(-9))., Conclusions: We identified 2 loci associated with risk of BE and provided data to support a further locus. The genes we found to be associated with risk for BE encode transcription factors involved in thoracic, diaphragmatic, and esophageal development or proteins involved in the inflammatory response., (Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
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41. Reply: To PMID 23673354.
- Author
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Corley DA
- Subjects
- Female, Humans, Male, Adenocarcinoma mortality, Barrett Esophagus pathology, Esophageal Neoplasms mortality
- Published
- 2014
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42. Impact of endoscopic surveillance on mortality from Barrett's esophagus-associated esophageal adenocarcinomas.
- Author
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Corley DA, Mehtani K, Quesenberry C, Zhao W, de Boer J, and Weiss NS
- Subjects
- Adenocarcinoma pathology, Aged, Aged, 80 and over, Case-Control Studies, Early Detection of Cancer, Esophageal Neoplasms pathology, Esophagoscopy, Female, Humans, Male, Middle Aged, Odds Ratio, Retrospective Studies, Adenocarcinoma mortality, Barrett Esophagus pathology, Esophageal Neoplasms mortality
- Abstract
Background & Aims: Although patients with Barrett's esophagus commonly undergo endoscopic surveillance, its effectiveness in reducing mortality from esophageal/gastroesophageal junction adenocarcinomas has not been evaluated rigorously., Methods: We performed a case-control study in a community-based setting. Among 8272 members with Barrett's esophagus, we identified 351 esophageal adenocarcinoma: 70 in persons who had a prior diagnosis of Barrett's esophagus (who were eligible for surveillance); 51 of these patients died, 38 as a result of the cancers (cases). Surveillance histories were contrasted with a sample of 101 living persons with Barrett's esophagus (controls), matched for age, sex, and duration of follow-up evaluation., Results: Surveillance within 3 years was not associated with a decreased risk of death from esophageal adenocarcinoma (adjusted odds ratio, 0.99; 95% confidence interval, 0.36-2.75). Fatal cases were nearly as likely to have received surveillance (55.3%) as were controls (60.4%). A Barrett's esophagus length longer than 3 cm and prior dysplasia each were associated with subsequent mortality, but adjustment for these did not change the main findings. Although all patients should be included in evaluations of effectiveness, excluding deaths related to cancer treatment and patients who failed to complete treatment, changed the magnitude, but not the significance, of the association (odds ratio, 0.46; 95% confidence interval, 0.13-1.64)., Conclusions: Endoscopic surveillance of patients with Barrett's esophagus was not associated with a substantially decreased risk of death from esophageal adenocarcinoma. The results do not exclude a small to moderate benefit. However, if such a benefit exists, our findings indicate that it is substantially smaller than currently estimated. The effectiveness of surveillance was influenced partially by the acceptability of existing treatments and the occurrence of treatment-associated mortality., (Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2013
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43. Can You Stop Surveillance After Radiofrequency Ablation of Barrett's Esophagus? A Glass Half Full.
- Author
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Corley DA
- Subjects
- Female, Humans, Male, Adenocarcinoma surgery, Barrett Esophagus surgery, Carcinoma in Situ surgery, Catheter Ablation, Esophageal Neoplasms surgery, Esophagoscopy methods, Esophagus pathology
- Published
- 2013
- Full Text
- View/download PDF
44. A combination of esomeprazole and aspirin reduces tissue concentrations of prostaglandin E(2) in patients with Barrett's esophagus.
- Author
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Falk GW, Buttar NS, Foster NR, Ziegler KL, Demars CJ, Romero Y, Marcon NE, Schnell T, Corley DA, Sharma P, Cruz-Correa MR, Hur C, Fleischer DE, Chak A, Devault KR, Weinberg DS, Della'Zanna G, Richmond E, Smyrk TC, Mandrekar SJ, and Limburg PJ
- Subjects
- Adult, Aged, Aged, 80 and over, Aspirin therapeutic use, Barrett Esophagus pathology, Biomarkers metabolism, Biopsy, Cyclooxygenase Inhibitors therapeutic use, Double-Blind Method, Down-Regulation, Drug Therapy, Combination, Esophagoscopy, Esophagus metabolism, Esophagus pathology, Female, Humans, Male, Middle Aged, Aspirin administration & dosage, Barrett Esophagus drug therapy, Barrett Esophagus metabolism, Cyclooxygenase Inhibitors administration & dosage, Dinoprostone metabolism, Esomeprazole therapeutic use, Proton Pump Inhibitors therapeutic use
- Abstract
Unlabelled: BACKGROUND& AIMS: Proton pump inhibitors and nonsteroidal anti-inflammatory drugs might prevent esophageal adenocarcinoma in patients with Barrett's esophagus (BE), but there are limited data from clinical trials to support this concept. We conducted a randomized, double-blind, placebo-controlled, phase 2 trial to assess the effects of the combination of aspirin (3 different doses) and esomeprazole on tissue concentrations of prostaglandin (PG) E(2) in patients with BE with no dysplasia or low-grade dysplasia., Methods: Participants were recruited through the multicenter Cancer Prevention Network and randomly assigned to groups that were given 40 mg esomeprazole twice daily in combination with an aspirin placebo once daily (arm A; n = 30), with 81 mg aspirin once daily (arm B; n = 47), or with 325 mg aspirin once daily (arm C; n = 45) for 28 days. We collected esophageal biopsy specimens before and after the intervention period to determine the absolute change in mean concentration of PGE(2) (the primary end point)., Results: Based on data from 114 patients, baseline characteristics were similar among groups. The absolute mean tissue concentration of PGE(2) was reduced by 67.6 ± 229.68 pg/mL in arm A, 123.9 ± 284.0 pg/mL in arm B (P = .10 vs arm A), and 174.9 ± 263.62 pg/mL in arm C (P = .02 vs arm A)., Conclusions: In combination with esomeprazole, short-term administration of higher doses of aspirin, but not lower doses or no aspirin, significantly reduced tissue concentrations of PGE(2) in patients with BE with either no dysplasia or low-grade dysplasia. These data support further evaluation of higher doses of aspirin and esomeprazole to prevent esophageal adenocarcinoma in these patients. Clinical trial registration number NCT00474903., (Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2012
- Full Text
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45. Barrett's esophagus: who should receive ablation and how can we get the best results?
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Bergman JJGHM and Corley DA
- Subjects
- Humans, Male, Barrett Esophagus economics, Barrett Esophagus surgery, Catheter Ablation economics, Endoscopy, Gastrointestinal economics, Esophagus surgery, Gastroesophageal Reflux complications, Health Care Costs, Precancerous Conditions economics, Precancerous Conditions surgery
- Published
- 2012
- Full Text
- View/download PDF
46. Consensus statements for management of Barrett's dysplasia and early-stage esophageal adenocarcinoma, based on a Delphi process.
- Author
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Bennett C, Vakil N, Bergman J, Harrison R, Odze R, Vieth M, Sanders S, Gay L, Pech O, Longcroft-Wheaton G, Romero Y, Inadomi J, Tack J, Corley DA, Manner H, Green S, Al Dulaimi D, Ali H, Allum B, Anderson M, Curtis H, Falk G, Fennerty MB, Fullarton G, Krishnadath K, Meltzer SJ, Armstrong D, Ganz R, Cengia G, Going JJ, Goldblum J, Gordon C, Grabsch H, Haigh C, Hongo M, Johnston D, Forbes-Young R, Kay E, Kaye P, Lerut T, Lovat LB, Lundell L, Mairs P, Shimoda T, Spechler S, Sontag S, Malfertheiner P, Murray I, Nanji M, Poller D, Ragunath K, Regula J, Cestari R, Shepherd N, Singh R, Stein HJ, Talley NJ, Galmiche JP, Tham TC, Watson P, Yerian L, Rugge M, Rice TW, Hart J, Gittens S, Hewin D, Hochberger J, Kahrilas P, Preston S, Sampliner R, Sharma P, Stuart R, Wang K, Waxman I, Abley C, Loft D, Penman I, Shaheen NJ, Chak A, Davies G, Dunn L, Falck-Ytter Y, Decaestecker J, Bhandari P, Ell C, Griffin SM, Attwood S, Barr H, Allen J, Ferguson MK, Moayyedi P, and Jankowski JA
- Subjects
- Adenocarcinoma diagnosis, Adenocarcinoma etiology, Adenocarcinoma mortality, Barrett Esophagus complications, Barrett Esophagus diagnosis, Barrett Esophagus mortality, Delphi Technique, Disease Progression, Esophageal Neoplasms diagnosis, Esophageal Neoplasms etiology, Esophageal Neoplasms mortality, Humans, Risk, Adenocarcinoma therapy, Barrett Esophagus therapy, Catheter Ablation, Esophageal Neoplasms therapy, Esophagectomy mortality, Esophagoscopy
- Abstract
Background & Aims: Esophageal adenocarcinoma (EA) is increasingly common among patients with Barrett's esophagus (BE). We aimed to provide consensus recommendations based on the medical literature that clinicians could use to manage patients with BE and low-grade dysplasia, high-grade dysplasia (HGD), or early-stage EA., Methods: We performed an international, multidisciplinary, systematic, evidence-based review of different management strategies for patients with BE and dysplasia or early-stage EA. We used a Delphi process to develop consensus statements. The results of literature searches were screened using a unique, interactive, Web-based data-sifting platform; we used 11,904 papers to inform the choice of statements selected. An a priori threshold of 80% agreement was used to establish consensus for each statement., Results: Eighty-one of the 91 statements achieved consensus despite generally low quality of evidence, including 8 clinical statements: (1) specimens from endoscopic resection are better than biopsies for staging lesions, (2) it is important to carefully map the size of the dysplastic areas, (3) patients that receive ablative or surgical therapy require endoscopic follow-up, (4) high-resolution endoscopy is necessary for accurate diagnosis, (5) endoscopic therapy for HGD is preferred to surveillance, (6) endoscopic therapy for HGD is preferred to surgery, (7) the combination of endoscopic resection and radiofrequency ablation is the most effective therapy, and (8) after endoscopic removal of lesions from patients with HGD, all areas of BE should be ablated., Conclusions: We developed a data-sifting platform and used the Delphi process to create evidence-based consensus statements for the management of patients with BE and early-stage EA. This approach identified important clinical features of the diseases and areas for future studies., (Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2012
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- View/download PDF
47. Cigarette smoking increases risk of Barrett's esophagus: an analysis of the Barrett's and Esophageal Adenocarcinoma Consortium.
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Cook MB, Shaheen NJ, Anderson LA, Giffen C, Chow WH, Vaughan TL, Whiteman DC, and Corley DA
- Subjects
- Aged, Australia, Case-Control Studies, Female, Gastroesophageal Reflux complications, Heartburn complications, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Risk Assessment, Risk Factors, Time Factors, United States, Adenocarcinoma etiology, Barrett Esophagus etiology, Esophageal Neoplasms etiology, Precancerous Conditions etiology, Smoking adverse effects
- Abstract
Background & Aims: Cigarette smoking has been implicated in the etiology of esophageal adenocarcinoma, but it is not clear if smoking is a risk factor for Barrett's esophagus. We investigated whether tobacco smoking and other factors increase risk for Barrett's esophagus., Methods: We analyzed data from 5 case-control studies included in the international Barrett's and Esophageal Adenocarcinoma Consortium. We compared data from subjects with Barrett's esophagus (n = 1059) with those from subjects with gastroesophageal reflux disease (gastroesophageal reflux disease controls, n = 1332), and population-based controls (n = 1143), using multivariable logistic regression models to test associations with cigarette smoking. We also tested whether cigarette smoking has synergistic effects with other exposures, which might further increase risk for Barrett's esophagus., Results: Subjects with Barrett's esophagus were significantly more likely to have ever smoked cigarettes than the population-based controls (odds ratio [OR] = 1.67; 95% confidence interval [CI]: 1.04-2.67) or gastroesophageal reflux disease controls (OR = 1.61; 95% CI: 1.33-1.96). Increasing pack-years of smoking increased the risk for Barrett's esophagus. There was evidence of a synergy between ever-smoking and heartburn or regurgitation; the attributable proportion of disease among individuals who ever smoked and had heartburn or regurgitation was estimated to be 0.39 (95% CI: 0.25-0.52)., Conclusions: Cigarette smoking is a risk factor for Barrett's esophagus. The association was strengthened with increased exposure to smoking until ∼20 pack-years, when it began to plateau. Smoking has synergistic effects with heartburn or regurgitation, indicating that there are various pathways by which tobacco smoking might contribute to development of Barrett's esophagus., (Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
48. Nonsteroidal anti-inflammatory drug use reduces risk of adenocarcinomas of the esophagus and esophagogastric junction in a pooled analysis.
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Liao LM, Vaughan TL, Corley DA, Cook MB, Casson AG, Kamangar F, Abnet CC, Risch HA, Giffen C, Freedman ND, Chow WH, Sadeghi S, Pandeya N, Whiteman DC, Murray LJ, Bernstein L, Gammon MD, and Wu AH
- Subjects
- Adenocarcinoma epidemiology, Adenocarcinoma pathology, Adolescent, Adult, Aged, Aged, 80 and over, Australia epidemiology, Canada epidemiology, Case-Control Studies, Cohort Studies, Esophageal Neoplasms epidemiology, Esophageal Neoplasms pathology, Esophagogastric Junction pathology, Female, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Risk Assessment, Risk Factors, Stomach Neoplasms epidemiology, Stomach Neoplasms pathology, Time Factors, United States epidemiology, Young Adult, Adenocarcinoma prevention & control, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Anticarcinogenic Agents therapeutic use, Esophageal Neoplasms prevention & control, Esophagogastric Junction drug effects, Stomach Neoplasms prevention & control
- Abstract
Background & Aims: Regular use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) has been reported to reduce risks of esophageal adenocarcinoma (EAC) and esophagogastric junctional adenocarcinoma (EGJA). However, individual studies have been too small to accurately assess the effects of medication type, frequency, or duration of use. We performed a pooled analysis to investigate these associations., Methods: We performed a pooled analysis of 6 population-based studies within the Barrett's and Esophageal Adenocarcinoma Consortium to evaluate the association between NSAID use and the risk of EAC and EGJA, using uniform exposure definitions. We collected information from 6 studies (5 case-control and 1 cohort), with a total of 1226 EAC and 1140 EGJA cases, on aspirin and/or NSAID use. Study-specific odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariate adjusted logistic regression models and then pooled using a random effects meta-analysis model., Results: Compared with nonusers, individuals who have used NSAIDs had a statistically significant reduced risk of EAC (OR, 0.68; 95% CI, 0.56-0.83); they also appeared to have a reduced risk of EGJA (OR, 0.83; 95% CI, 0.66-1.03). Similar reductions in risk were observed among individuals who took aspirin or nonaspirin NSAIDs. The highest levels of frequency (daily or more frequently) and duration (≥10 years) of NSAID use were associated with an approximately 40% reduction in risk of EAC, with ORs of 0.56 (95% CI, 0.43-0.73; P(trend) < .001) and 0.63 (95% CI, 0.45-0.90; P(trend) = .04), respectively., Conclusions: Although reverse causation could, in part, explain the inverse association observed between NSAID use and EAC risk, our pooled analysis suggests a possible role for NSAIDs in prevention of adenocarcinomas of the esophagus and esophagogastric junction., (Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2012
- Full Text
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49. The future of colon cancer screening: what do we recommend and will it be too much, too little, or just right?
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Corley DA
- Subjects
- Colonic Neoplasms mortality, Colonoscopy, Humans, Risk Assessment, Colonic Neoplasms diagnosis, Early Detection of Cancer trends
- Published
- 2011
- Full Text
- View/download PDF
50. Proton pump inhibitors and histamine-2 receptor antagonists are associated with hip fractures among at-risk patients.
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Corley DA, Kubo A, Zhao W, and Quesenberry C
- Subjects
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Case-Control Studies, Dose-Response Relationship, Drug, Female, Gastric Acid metabolism, Hip Fractures epidemiology, Humans, Incidence, Male, Middle Aged, Risk Factors, Hip Fractures chemically induced, Histamine H2 Antagonists adverse effects, Proton Pump Inhibitors adverse effects
- Abstract
Background & Aims: Drugs that inhibit gastric acid might increase the risk of hip fracture. However, little long-term exposure data exist and no large studies have been conducted in the United States., Methods: We conducted a case-control study using data from an integrated health services organization. We evaluated 33,752 patients with incident diagnoses of hip/femur fractures (cases), 130,471 matched members without fractures (controls), prescription data for use of proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs) (up to 10 years' cumulative duration), and confounders., Results: Patients with hip fractures were more likely than controls to have previously received a > or =2-year supply of PPIs (odds ratio [OR], 1.30; 95% confidence interval [CI], 1.21-1.39) or H2RAs (OR, 1.18; 95% CI, 1.08-1.29). The risk was reduced after discontinuation of medication (OR of 1.30 [95% CI, 1.21-1.41] for current PPI users vs OR of 1.09 [95% CI, 0.64-1.85] for patients who received their last prescription 2-2.9 years ago). Higher dosages (but not increasing cumulative durations) were associated with increased risk (eg, > or =1.5 pills/day: OR, 1.41 [95% CI, 1.21-1.64]; <0.74 pills/day: OR, 1.12 [95% CI, 0.94-1.33]). Excess fracture risk for PPI use was only present among persons with at least one other fracture risk factor., Conclusions: Use of drugs that inhibit gastric acid is associated with an increased risk of hip fracture; however, this association was only found among persons with at least one other risk factor for hip fracture. Acid inhibition might therefore be associated with fracture risk in persons already at risk for osteoporosis, although other confounding cannot be excluded., (Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2010
- Full Text
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