# Diabetes, Medications and the Cost-Effectiveness of Screening for Colorectal Neoplasia

> **NIH NIH K07** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2022 · $158,153

## Abstract

Project Summary/Abstract: The candidate's long-term career goal is to become an independent investigator
with transdisciplinary expertise in cancer epidemiology, biomedical informatics, pharmacoepidemiology, and
health economic modeling and evaluation. The focused didactic training, mentorship, and experiential learning
through research activities proposed in this award will facilitate the development of critical skills in the pursuit of
knowledge to inform and improve cancer prevention and screening. The candidate's research is motivated by
the recognition that type-2 diabetes mellitus (T2DM) patients are at a 30-40% increased risk for colorectal
cancer (CRC), and that anti-diabetic drugs may also alter CRC risk. Thus, this high-risk group presents an
opportunity for targeted screening and early detection of CRC. Currently, CRC screening is based on age and
family history, with no consideration for comorbidities, including T2DM. Building on her previous work in cancer
epidemiology, the candidate seeks to determine the association between T2DM and risk of colorectal polyps:
overall, by subtypes, and by lesion severity, individually reflecting different molecular pathways (Aim 1); and to
examine the risk for colorectal polyps associated with anti-diabetic therapy: overall, by subtypes, and by lesion
severity (Aim 2). These aims will be addressed by leveraging the rich resources of an existing colonoscopy-
based cohort at the University of Washington Medical Center's (UWMC) Gastroenterology clinic established
during 2003-2011. Demographics, select lifestyle factors, and detailed histopathology have been previously
abstracted from UWMC's electronic medical records (EMR) database. The candidate proposes to extend this
cohort through 2017 (N~38,000), and enhance it by linking existing data with diabetes-related variables from
the EMR database using biomedical informatics (e.g., natural language processing, clinical text mining) to
estimate the risk for colorectal neoplasia. Using these empirical estimates derived from Aims 1 and 2, the
candidate will then build a microsimulation model projecting the risk for colorectal neoplasia in T2DM patients,
accounting for their diabetes therapy. Alternative screening and treatment strategies, including altering the
screening start-age, modifying diabetes treatment, or altering screening modality among T2DM patients, will be
evaluated for their cost-effectiveness (Aim 3). This work may help inform targeted screening recommendations
that could, in turn, lower the incidence and mortality of CRC among persons with T2DM, and improve the cost-
effectiveness of CRC screening. The candidate has proposed a training and career development plan that
builds upon her prior skills in cancer epidemiology to gain experience and proficiency in biomedical informatics,
pharmacoepidemiology, and health economic modeling and evaluation, including cost-effectiveness
approaches. The transdisciplinary mentorship team, comprised of nati...

## Key facts

- **NIH application ID:** 10479816
- **Project number:** 5K07CA222060-05
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** Sheetal Hardikar
- **Activity code:** K07 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $158,153
- **Award type:** 5
- **Project period:** 2018-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10479816

## Citation

> US National Institutes of Health, RePORTER application 10479816, Diabetes, Medications and the Cost-Effectiveness of Screening for Colorectal Neoplasia (5K07CA222060-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10479816. Licensed CC0.

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