# Personalized Colorectal Cancer Prevention: Integrating Individual Screening and Follow Up Information with Genetic Data

> **NIH VA IK2** · DURHAM VA MEDICAL CENTER · 2024 · —

## Abstract

This is the first resubmission of a BLR&D CDA-2 proposal to provide five years of salary support to Brian Sullivan,
M.D. M.H.S., toward his goal of developing an independent VA research career. Dr. Sullivan is an Investigator
at the Durham Cooperative Studies Epidemiology Center (CSPEC), Directory of Quality at the Durham VA
Medical Center, and Assistant Professor at Duke University in the Department of Medicine.
The long-term goal of this CDA is to provide Dr. Sullivan with the training and resources needed to lead a multi-
disciplinary VA research program focused on colorectal cancer (CRC) prevention. There is considerable
variability in individual risk of CRC that could impact age at initiation of CRC screening, screening modality
choice, and frequency of follow-up. Yet, guidelines do not recognize this variability, performing too much
colonoscopy screening and surveillance in low risk individuals and not providing enough or timely screening and
surveillance in high-risk individuals. More precise risk stratification based on clinical and genetic factors offers a
promising strategy to improve CRC prevention by targeting colonoscopy resources to individuals at increased
risk for CRC, while reducing the costs and harms of invasive procedures in those at low risk who could undergo
delayed or non-invasive screening. This CDA will leverage powerful VA resources, including linked clinical
repositories and genomic biobanks, to enhance current CRC risk-assessment algorithms with individual-level
information to develop cost-effective and “smarter” CRC risk prediction tools that can guide cancer prevention.
Building on his prior work, Dr. Sullivan's short-term CDA goal is to create an accurate CRC risk prediction tool
based on the clinical and genetic profiles of Veterans to improve CRC risk prediction and better target CRC
screening resources. Specifically, he will establish a CRC risk cohort derived from natural language processing
(NLP)-based phenotype algorithms to more accurately identify cases of CRC and advanced precancerous
lesions in large VA administrative databases, then apply emerging statistical models for longitudinal cohorts that
incorporates clinical information from prior screenings (if available) or other testing to allow informative estimates
of CRC risk over time while taking competing risks of mortality into account (Aim 1). He will then link this database
to the racially diverse Million Veteran Program (MVP) biorepository to test if additional CRC genomic discovery
can bridge disparities and identify those at risk for CRC by creating a trans-ancestry polygenic risk score (Aim
2). Finally, he will augment genetic tools with known longitudinal CRC risk factors to create an accurate CRC
risk prediction tool (Aim 3). This work will support future Merit applications for prospective validation and
implementation studies of this tool. Dr. Sullivan has a team of expert mentors (including Drs. Elizabeth Hauser,
Jason Dominitz, David Lieberma...

## Key facts

- **NIH application ID:** 10925426
- **Project number:** 1IK2BX006452-01A1
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Brian Andrew Sullivan
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-08-01 → 2029-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10925426

## Citation

> US National Institutes of Health, RePORTER application 10925426, Personalized Colorectal Cancer Prevention: Integrating Individual Screening and Follow Up Information with Genetic Data (1IK2BX006452-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10925426. Licensed CC0.

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