Racial Disparity in Barrett's Esophagus
Condition: Barrett's Esophagus; Gastroesophageal Reflux Disease (GERD); Intestinal Metaplasia
MeSH terms: Barrett Esophagus; Gastroesophageal Reflux; Metaplasia
Study type: Observational

Summary: 
      The goal of the proposed research is to investigate the molecular mechanisms of racial
      disparity in Barrett's esophagus (BE), the premalignant lesion of esophageal adenocarcinoma.
      Specifically, the investigators hypothesize that environmental factors, genetic factors, and
      potentially gene environment interactions play crucial roles in the observed racial disparity
      in developing Barrett's esophagus.

      Patients are recruited through UNC hospitals prior to scheduled esophagogastroduodenoscopy
      (EGD). Participants complete a questionnaire, have body measurements obtained, and have
      blood, biopsies, and gastric aspirate collected. Participants also complete a 24 hour pH
      impedance test.
    

Detailed description: 
      The goal of the proposed research is to investigate the molecular mechanisms of racial
      disparity in Barrett's esophagus, the premalignant lesion of esophageal adenocarcinoma.
      Specifically, the investigators hypothesize that environmental factors, genetic factors, and
      potentially gene environment interactions play crucial roles in the observed racial disparity
      in developing Barrett's esophagus.

      Participants: Patients aged 18-80 presenting at the Gastrointestinal (Gl) Endoscopy Clinic at
      UNC-Chapel Hill for elective upper endoscopy with a primary or secondary indication of reflux
      symptoms.

      Procedures (methods): Endoscopic biopsy, pH impedance and sampling of gastric secretions will
      be performed according to our standard protocol. A series of questionnaires assessing
      demographics, environmental exposure (e.g., smoking, drinking), markers of socioeconomic
      status (SES), body measurement, previous health history, and gastroesophageal reflux disease
      (GERD) symptomatology will be administered to our subjects.
    

Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        The source of the study population will be patients aged 18-80 presenting at the
        gastrointestinal (Gl) Endoscopy Clinic at UNC-Chapel Hill for elective upper endoscopy with
        a primary or secondary indication of reflux symptoms. Any patient undergoing endoscopy with
        classic reflux symptoms is eligible to participate in the study. These symptoms include a
        substernal chest burning or warmth, a "waterbrash" sensation, regurgitation, or any chest
        pain worst when supine or after meals.

        Race will be self-identified race or ethnicity (SIRE) from a researcher-provided list.
        According to the NIH Policy on Reporting Race and Ethnicity Data published in August 8,
        2001 (NOT-OD-01-053), we will "use two separate questions with ethnicity information
        collected first followed by the option to select more than one racial designation."
        Patients in this study should be "Not Hispanic or Latino", and either "African American" or
        "White".
      
Biospecimen description: 
      serum, plasma, buffy, esophageal biopsies
    
Keywords: Barrett's Esophagus (BE); Intestinal metaplasia; Gastroesophageal reflux disease (GERD); Racial Disparity