aAzma Shaukat, MD, MPH, a gastroenterologist and population health specialist at New York University Langone Health’s Perlmutter Cancer Center, discusses colorectal cancer risk factors, screening methods, long-term outcomes, and He leads an outcomes research program focused on the study of endoscopy quality indicators. A highly regarded clinician, epidemiologist, and researcher, Dr. Shaukat is dedicated to minimizing barriers and increasing colorectal cancer screening in underserved communities in Brooklyn and beyond. We are also researching ways to improve it.
Dr. Shaukat is the Robert M. and Mary H. Glickman Professor of Medicine. Faculty of Medicine and a university professor Department of Population Health At New York University Grossman School of Medicine, he discusses his interest in the impact of colorectal cancer treatment and screening on population health, his research on the use of artificial intelligence (AI) to improve the quality of colonoscopies, and more. I did.
What is your background and how did you become interested in colorectal cancer and its impact on people’s health?
After graduating from medical school, I wanted to concentrate on clinical research. I received training in epidemiology at the Johns Hopkins Bloomberg School of Public Health, where I developed ideas about population health. When I started my clinical training, my focus was on things that I often see in the clinic that impact people’s health. Colon cancer screening and prevention was one area that I was very interested in. That’s because colon cancer is a very common cancer and the third most common cancer in both men and women in the United States. And despite the role of prevention through dietary and lifestyle changes, chemoprevention with supplements such as calcium and vitamin D, and better screening tests, we still carry a significant burden of this disease. I decided to focus on all aspects of colorectal cancer prevention because I thought this was an area where I could focus both clinically and research-wise.
How did that lead to your current research interests?
One of my major research questions revolves around the impact of screening efforts on clinical outcomes. Who does screening help, and are there ways to do it better to reduce the burden of colon cancer and reduce colon cancer deaths at a population level?
After completing a gastroenterology fellowship at Emory University School of Medicine, I decided to attend the University of Minnesota. MINN surveyThe first and only randomized clinical trial of colon cancer screening in the United States to date was conducted there. The test, which he started in 1975, randomly assigned 46,000 people to “screening” or “no screening” and found that screening reduced colon cancer and colon cancer deaths. So we wanted to dig deeper into the data to answer bigger picture questions. Is it a benefit that lasts for 30 years? And are the benefits the same across all age groups, not just men and women? Despite being screened, there are still risks that increase your risk of colon cancer. Are there any factors (diet, smoking, obesity, etc.)?
We finally published our findings New England Medical JournalThis study showed that screening is highly effective and that its effectiveness varies between men and women and across age groups. From there, I also began research to understand new testing methods. And it’s an interesting field. There is potential for a blood-based test to be used as a screening tool to improve screening rates and refer those who test positive for a colonoscopy. Understanding whether that strategy can improve outcomes for individuals who undergo screening and help diagnose cancer at an earlier stage is part of my current research focus at NYU Langone. This is the department.
Another aspect of our efforts is to improve screening in populations with low screening rates. Disparities are greatest in the New York City metropolitan area, where neighborhoods vary widely in screening rates and, as a result, in cancer incidence and mortality. One of my grants is aimed at improving colon cancer screening at several federally qualified medical centers in Brooklyn. We are committed to proactively reaching out to targeted populations, guiding them toward screening, helping them overcome the barriers they face, and demonstrating that screening can be improved. and improve outcomes.
How does your work as a gastroenterologist and population health researcher involve researchers and health care providers at Perlmutter Cancer Center?
Perlmutter Cancer Center is truly an amazing resource. We have very extensive community involvement and many of our Cancer Center members are knowledgeable, but they also have many of the skills required for a team-based approach. We have people with expertise not only in treatment and prognosis, but also in prevention. I collaborate with such colleagues and use their expertise and connections to identify which populations we need to reach, establish connections with these populations, and utilize the cancer center’s I’ve been very fortunate to be able to use and leverage some of the navigation and other networks. Thank you for our intervention to improve testing rates. Community engagement and navigation, coupled with connecting patients to the right type of cancer treatment, has been invaluable to my job.
How does your research in population health contribute to the care of patients with colorectal cancer?
We strive to prevent people from developing colorectal cancer. We focus on average risk populations. These are men and women over the age of 45 who have not been screened or who have been screened but have not completed the full range of subsequent care. Part of what we’re trying to do is provide care to these people and also study these blood-based cancer tests at a population level to increase the number of people who need colonoscopies. The goal is to be able to properly stratify and identify risks. Some of my other work is based on improving the quality of colonoscopies with AI and other tools, making colonoscopies easier by detecting and removing precancerous polyps. We aim to provide effective treatment to prevent the occurrence of cancer. In 2022, we will Presented the results of a randomized multicenter study The use of AI-powered colonoscopy was shown to improve the overall detection rate of cancerous and precancerous polyps in average-risk patients by 27%.
Ultimately, our research could reduce the number of cancer cases diagnosed, especially at later stages, and reduce some of the work of oncologists, allowing them to focus on treatable cancers with better prognoses. It is intended to be.
Along these lines, how do gastroenterologists collaborate with oncologists to provide care for colorectal cancer patients?
Gastroenterologists are considered part of the multidisciplinary team and have many complementary treatment models that they share with medical oncologists. For example, some types of colon cancer develop from colon polyps. The first issue is whether it should be removed completely endoscopically, leaving the patient without the need for surgery. The second aspect is staging the cancer and getting the appropriate treatment for the cancer, and this is where we rely on our oncology colleagues. Our multidisciplinary team meeting “Tumor Board” discusses the treatment of many cancers where gastroenterologists may play a role in endoscopic resection and follow-up in terms of surveillance. Let’s discuss. Medical oncologists, radiation oncologists, and surgical oncologists also participate in determining the best treatment model to treat cancer and prevent recurrence. We believe this model provides excellent care and allows everyone to bring their expertise to the table to achieve the best outcomes for patients.
One of Perlmutter Cancer Center’s major efforts is to reach out to the communities we serve. This allows us to demonstrate our reach and ability to help the communities around us, rather than just waiting for patients to come to us and be seen in our clinic. May we be as good as possible. I am very excited and excited to be a part of these ongoing efforts. We will continue to expand and aim to introduce a system that can automate colonoscopy using AI. Additionally, if we detect cancer or polyps that are becoming cancerous in certain high-risk patients, we will be able to identify them. Let’s take care of them before they even think about contacting us. These are part of a streamlined care model that I hope we can develop together as a team.