Project title: Establishing an All- Ireland Collaboration Targeting prevention and early Diagnosis of Oesophageal cancer through Registration of Patients with Barrett’s oesophagus and development of Bio-Resource.

Main research Goals

Objective: To target oesophageal cancer prevention and early diagnosis through registration of at-risk patients with a diagnosis of Barrett’s oesophagus and storing biopsies for research.The initiative will enable improved monitoring ,surveillance, education, patient information and collaborative epidemiological, clinical and scientific research.

Specific Aims:

1. To establish the first Barrett’s Register in the Republic of Ireland with linkage to the existing Northern Ireland Barrett’s Register.
   
2. To establish a repository of biopsy material in participating Molecular Medicine Centres with existing biobanking resources. This will facilitate clinical and molecular research targeting oesophageal cancer prevention, as well as international collaboration.

Background to this research proposal.

Barrett’s oesophagus is increasingly diagnosed in Ireland and other Western countries and is the sole recognized precursor of Oesophageal adenocarcinoma. It arises from chronic reflux and can be identified at endoscopy and confirmed by a biopsy showing specialized intestinal metaplasia (SIM ).Barrett’s is present in up to 10% of patients undergoing endoscopy for reflux, and some estimates suggest a population prevalence of 1.6%. The incidence of oesophageal adenocarcinoma is rising rapidly, and targeting Barrett’s patients is a logical approach in initiatives aimed at both reducing the incidence of oesophageal cancer and permitting a greater chance of cure through an early diagnosis. At this time however, and in contrast to Northern Ireland and many European countries, Barrett’s patients are not registered, surveillance and management is not standardized, and no structure exists to enable clinical and scientific research and enhance potential international collaboration.

Relevance to Oesophageal Cancer Patients.

Over 90% of cases of oesophageal adenocarcinoma arise in a background of Barrett’s oesophagus .Patients with Barrett’s are naturally anxious about the cancer risk, and this programme will enable registration, surveillance, standardization of care, and collaborative epidemiological and scientific research.