Gastrointestinal Cancer Research Program

The Gastrointestinal Cancer Research Program in the Division of Gastroenterology covers cancers of all digestive organs, with a concentration in three main areas: Colorectal cancer (CRC), neuroendocrine tumors (NETs) and familial pancreatic cancer. The hepatocellular carcinoma program is administered by the Division of Liver Diseases and the Recanati Miller Transplant Institute. 

Efforts in the field of CRC focus on improving access to screening colonoscopy among underserved individuals, developing novel non-invasive stool-based CRC screening tests, screening high-risk individuals, and exploring the intestinal microbiome in individuals at high risk of CRC. The Mount Sinai team was among the first in the nation to prove the importance of using patient navigators to improve screening colonoscopy rates among minority individuals and demonstrate the cost-effectiveness of this approach. The team has been involved with the testing of first-, second- and third-generation stool DNA tests for CRC screening, including one that is now FDA approved and commercially available. Investigators have been at the forefront of research into risk factors for CRC among patients with chronic inflammatory bowel disease (IBD), as well as testing new imaging techniques such as chromoendoscopy, and advanced polyp removal techniques in patients with IBD and other high-risk conditions. A new Registry was just launched to better understand whether patients with IBD who have a history of any type of cancer, are at greater risk of recurrent or new cancers depending upon the type of medical treatment they receive for their IBD.

Research on small intestinal and pancreatic NETs has helped to refine prognostic predictions using a more detailed analysis of tumor stage.  A large registry of individuals with neuroendocrine tumors facilitates patient education and enrollment of patients into clinical trials. Studies are clarifying risk and management of individuals at high risk for pancreatic cancer, especially those with a genetic predisposition. The latest advanced endoscopy techniques are used for diagnosing and treating cancers throughout the GI tract. 




1. Cooks T, Pateras IS, Tarcic I, Solomon H, Schetter AJ, Wilder S, Lozano G, Pikarsky E, Forshew T, Rozenfeld N, Harpaz N, Itzkowitz S, Harris CC, Rotter V, Gorgoulis VG, Oren M. Mutant p53 prolongs NF-kappaB activation and promotes chronic inflammation and inflammation-associated colorectal cancer. Cancer Cell, 23:634-46, 2013. PMID: 23680148

2. Jandorf, L., Stossel, L.M., Cooperman, J.L., Graff Zivin, J., Ladabaum, U., Hall, D., Thélémaque, L.D., Redd, W., Itzkowitz, S.H.  Cost analysis of a patient navigation system to enhance screening colonoscopy adherence among urban minorities, Cancer, 2013, 119(3): 612-20. doi: 10.1002/cncr.27759. 

3. Kisiel JB, Yab TC, Nazer Hussain FT, Taylor WR, Garrity-Park MM, Sandborn WJ, Loftus EV, Wolff BG, Smyrk TC, Itzkowitz SH, Rubin DT, Zou H, Mahoney DW, Ahlquist DA. Stool DNA testing for the detection of colorectal neoplasia in patients with inflammatory bowel disease. Aliment Pharmacol Ther 37(5):546-554, 2013. PMID: 23347191

4. Jandorf L, Braschi C, Ernstoff E, Wong CR, Thelemaque LD, Winkel G, Thompson H, Redd WH, Itzkowitz SH. Culturally targeted patient navigation for increasing african americans’ adherence to screening colonoscopy: a randomized clinical trial. Cancer Epidemiol Biomarkers Prev. 221577-87, 2013. PMID: 23753039 

5. Imperiale TF, Ransohoff DF, Itzkowitz SH, Levin TR, Lavin P, Lidgard GP, Ahlquist DA, Berger BM. Multitarget stool DNA testing for colorectal-cancer screening. New Engl J Med, 370(14):1287-97, 2014. PMID: 24645800

6. Lee KK, Jandorf L, Thelemaque L, Itzkowitz SH. Colorectal neoplasia detection among black and Latino individuals undergoing screening colonoscopy: a prospective cohort study. Gastrointest Endosc 79:466-72, 2014. PMID: 24528828

7. Ladabaum U, Mannalithara A, Jandorf L, Itzkowitz SH. Cost-effectiveness of patient navigation to increase adherence with screening colonoscopy among minority individuals. Cancer 121:1088-97, 2015. PMID: 2549245

8. Lee KK, Jandorf L, Itzkowitz SH. Diminutive polyps among black and Latino populations undergoing screening colonoscopy: evidence supporting a resect and discard approach. Gastrointest Endosc 81:728-32, 2015. PMID: 25708761

9. Beaugerie L, Itzkowitz SH. Cancers complicating inflammatory bowel disease. N Engl J Med 372:1441-52, Apr 9, 2015. PMID: 25853748

10. Axelrad J, Bernheim O, Colombel JF, Malerba S, Ananthakrishnan A, Yajnik V, Hoffman G, Agrawal M, Lukin D, Desai A, McEachern E, Bosworth B, Scherl E, Reyes A, Zaidi H, Mudireddy P, DiCaprio D, Sultan K, Korelitz B, Wang E, Williams R, Chen L, Katz S, Itzkowitz SH; New York Crohn’s and Colitis Organization (NYCCO). Risk of new or recurrent cancer in patients with inflammatory bowel disease and previous cancer exposed to immunosuppressive and anti-TNF agents. Clin Gastroenterol Hepatol. 14:58-64, 2016. PMID:26247164 

11. Itzkowitz SH, Winawer SJ, Krauskopf M, Carlesimo M, Schnoll-Sussman FH, Huang K, Weber TK, Jandorf L. New York Citywide Colon Cancer Control Coalition: A public health effort to increase colon cancer screening and address health disparities. Cancer 122:269-277, 2016. PMID:26595055

12. Palmela C, Peerani F, Castaneda D, Torres J, Itzkowitz SH. Inflammatory Bowel Disease and Primary Sclerosing Cholangitis: A Review of the Phenotype and Associated Specific Features. Gut Liver. 2017 Apr 6. PMID:2837658

13. Martin JA, Warner RR, Wisnivesky JP, Kim MK. Improving survival prognostication of gastroenteropancreatic neuroendocrine neoplasms: Revised staging criteria. Eur J Cancer. 2017 May;76:197-204. PMID: 28334622

14. Kim MK, Ye F, Wang D, Cui M, Ward SC, Warner RR, Roayaie S, Shafir M, Schwartz M, Zhang D, Itzkowitz S.Differential Protein Expression in Small Intestinal Neuroendocrine Tumors and Liver Metastases. Pancreas. 2016 Apr;45(4):528-32. PMID:26474427

15. Kim MK, Warner RR, Ward SC, Harpaz N, Roayaie S, Schwartz ME, Itzkowitz S, Wisnivesky J Prognostic significance of lymph node metastases in small intestinal neuroendocrine tumors.Neuroendocrinology. 2015;101(1):58-65. PMID:25572143

16. Agarwal R, Szalkiewicz ER, Warner RR, Roayaie S, Hechtman JF, Zhu H, Kim MK Multiple endocrine neoplasia type 1 associated with a new mutation in the menin gene and a midgut neuroendocrine tumor. Pancreas. 2014 Jan;43(1):145-6. PMID:24326372

17. Weinstock B, Ward SC, Harpaz N, Warner RR, Itzkowitz S, Kim MK. Clinical and prognostic features of rectal neuroendocrine tumors. Neuroendocrinology. 2013;98(3):180-7. PMID:24080744

18. Kim MK, Warner RR, Roayaie S, Harpaz N, Ward SC, Itzkowitz S, Wisnivesky JP. Revised staging classification improves outcome prediction for small intestinal neuroendocrine tumors. J Clin Oncol. 2013 Oct 20;31(30):3776-81. PMID: 24043726

19. Amin S, Mhango G, Lin J, Aronson A, Wisnivesky J, Boffetta P, Lucas AL. Metformin Improves Survival in Patients with Pancreatic Ductal Adenocarcinoma and Pre-Existing Diabetes: A Propensity Score Analysis. Am J Gastroenterol. 2016 Sep;111(9):1350-7. PMID: 27430290

20. Lucas AL, Malvezzi M, Carioli G, Negri E, La Vecchia C, Boffetta P, Bosetti C. Global Trends in Pancreatic Cancer Mortality From 1980 Through 2013 and Predictions for 2017. Clin Gastroenterol Hepatol. 2016 Oct;14(10):1452-1462.e4. PMID:27266982

21. Lucas AL, Bravi F, Boffetta P, Polesel J, Serraino D, La Vecchia C, Bosetti C. Adherence to World Cancer Research Fund/American Institute for Cancer Research recommendations and pancreatic cancer risk. Cancer Epidemiol. 2016 Feb;40:15-21. PMID: 26605429

22. Lucas AL, Frado LE, Hwang C, Kumar S, Khanna LG, Levinson EJ, Chabot JA, Chung WK, Frucht H. BRCA1 and BRCA2 germline mutations are frequently demonstrated in both high-risk pancreatic cancer screening and pancreatic cancer cohorts. Cancer. 2014 Jul 1;120(13):1960-7. PMID: 24737347

23. Lucas AL, Shakya R, Lipsyc MD, Mitchel EB, Kumar S, Hwang C, Deng L, Devoe C, Chabot JA, Szabolcs M, Ludwig T, Chung WK, Frucht H. High prevalence of BRCA1 and BRCA2 germline mutations with loss of heterozygosity in a series of resected pancreatic adenocarcinoma and other neoplastic lesions. Clin Cancer Res. 2013 Jul 1;19(13):3396-403. PMID: 23658460

24. Hernandez YG, Lucas AL.MicroRNA in pancreatic ductal adenocarcinoma and its precursor lesions. World J Gastrointest Oncol. 2016 Jan 15;8(1):18-29. Review.PMID: 26798434

25. Lucas AL, Tarlecki A, Van Beck K, Lipton C, RoyChoudhury A, Levinson E, Kumar S, Chung WK, Frucht H, Genkinger JM. Self-Reported Questionnaire Detects Family History of Cancer in a Pancreatic Cancer Screening Program. J Genet Couns. 2016 Dec 30. PMID:28039657

26. Amin S, Yang DJ, Lucas AL, Gonzalez S, DiMaio CJ.There Is No Advantage to Transpapillary Pancreatic Duct Stenting for the Transmural Endoscopic Drainage of Pancreatic Fluid Collections: A Meta-Analysis. Clin Endosc. 2017 Apr 17. PMID: 28415167

27. Amin S, Boffetta P, Lucas AL.The Role of Common Pharmaceutical Agents on the Prevention and Treatment of Pancreatic Cancer. Gut Liver. 2016 Sep 15;10(5):665-71. doi: 10.5009/gnl15451. Review.PMID: 27563018

28. Hassid BG, Lucas AL, Salomao M, Weng C, Liu F, Khanna LG, Kumar S, Hwang C, Chabot JA, Frucht  Absence of pancreatic intraepithelial neoplasia predicts poor survival after resection of pancreatic cancer.Pancreas. 2014 Oct;43(7):1073-7. PMID: 24987871

29. Yang D, Amin S, Gonzalez S, Mullady D, Edmundowicz SA, DeWitt JM, Khashab MA, Wang AY, Nagula S, Buscaglia JM, Bucobo JC, Wagh MS, Draganov PV, Stevens T, Vargo JJ, Khara HS, Diehl DL, Keswani RN, Komanduri S, Yachimski PS, Prabhu A, Kwon RS, Watson RR, Goodman AJ, Benias P, Carr-Locke DL, DiMaio CJ.Clinical outcomes of EUS-guided drainage of debris-containing pancreatic pseudocysts: a large multicenter study. Endosc Int Open. 2017 Feb;5(2):E130-E136. PMID: 28210709

30. DiMaio CJ, Kolb JM, Benias PC, Shah H, Shah S, Haluszka O, Maranki J, Sharzehi K, Lam E, Gordon SR, Hyder SM, Kaimakliotis PZ, Allaparthi SB, Gress FG, Sethi A, Shah AR, Nieto J, Kaul V, Kothari S, Kothari TH, Ho S, Izzy MJ, Sharma NR, Watson RR, Muthusamy VR, Pleskow DK, Berzin TM, Sawhney M, Aljahdi E, Ryou M, Wong CK, Gupta P, Yang D, Gonzalez S, Adler DG.Initial experience with a novel EUS-guided core biopsy needle (SharkCore): results of a large North American multicenter study.Endosc Int Open. 2016 Sep;4(9):E974-9. PMID: 27652304

31. Adler DG, Witt B, Chadwick B, Wells J, Taylor LJ, Dimaio C, Schmidt R.Pathologic evaluation of a new endoscopic ultrasound needle designed to obtain core tissue samples: A pilot study. Endosc Ultrasound. 2016 May-Jun;5(3):178-83. doi: 10.4103/2303-9027.183976. PMID: 27386475

32. Amin S, DiMaio CJ, Kim MK. Surveillance of Asymptomatic Pancreatic Cysts - How Long is Long Enough?Gastroenterology. 2016 Jul;151(1):207-9. PMID:27238843

33. Yang D, Amin S, Gonzalez S, Mullady D, Hasak S, Gaddam S, Edmundowicz SA, Gromski MA, DeWitt JM, El Zein M, Khashab MA, Wang AY, Gaspar JP, Uppal DS, Nagula S, Kapadia S, Buscaglia JM, Bucobo JC, Schlachterman A, Wagh MS, Draganov PV, Jung MK, Stevens T, Vargo JJ, Khara HS, Huseini M, Diehl DL, Keswani RN, Law R, Komanduri S, Yachimski PS, DaVee T, Prabhu A, Lapp RT, Kwon RS, Watson RR, Goodman AJ, Chhabra N, Wang WJ, Benias P, Carr-Locke DL, DiMaio CJ.Transpapillary drainage has no added benefit on treatment outcomes in patients undergoing EUS-guided transmural drainage of pancreatic pseudocysts: a large multicenter study. Gastrointest Endosc. 2016 Apr;83(4):720-9. PMID:26548849

34. Marion JF, Waye JD, Israel Y, Present DH, Suprun M, Bodian C, Harpaz N, Chapman M, Itzkowitz S, Abreu MT, Ullman TA, McBride RB, Aisenberg J, Mayer L; Chromoendoscopy Study Group at Mount Sinai School of Medicine..Chromoendoscopy Is More Effective Than Standard Colonoscopy in Detecting Dysplasia During Long-term Surveillance of Patients With Colitis. Clin Gastroenterol Hepatol. 2016 May;14(5):713-9. PMID:26656297

35. Waye JD. Difficult colonoscopy.Gastroenterol Hepatol (N Y). 2013 Oct;9(10):676-8. PMID:24764784

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