Jeffrey K. Lee, MD, MPH

People

Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

jeffrey.k.lee@kp.org

Jeffrey K. Lee, MD, MPH, is a Research Scientist I at the Kaiser Permanente Northern California Division of Research and an attending gastroenterologist at Kaiser Permanente San Francisco Medical Center. His clinical focus is in general gastroenterology, colorectal cancer prevention, and hereditary gastrointestinal cancer syndromes. His research interests include: colorectal cancer prevention, gastrointenstinal cancer prevention, pharmacoepidemiology, diagnostic testing for gastrointestinal cancers, and improving the quality and safety of endoscopy and colonoscopy. He holds a Bachelor of Arts from the University of California, Berkeley, a Masters in Clinical Research from the University of California, San Diego, and a Doctorate in Medicine, also from UCSD. After medical school, he completed an internal medicine residency at UCSD; and a gastroenterology fellowship at the University of California, San Francisco. Prior to joining Kaiser Permanente, he practiced gastroenterology at UCSF Medical Center for several years.

Current Position(s):

Research Scientist I, Division of Research, Kaiser Permanente Northern California
Attending Gastroenterologist, Kaiser Permanente, San Francisco Medical Center
Assistant Clinical Professor of Medicine, University of California, San Francisco

Section Affiliations:

Cancer

Studies

Rates and Risk Factors of Post-Colonoscopy Colorectal Cancer in a Large, United States Population-based Cohort Study

Colorectal cancer (CRC) is the third leading cause of cancer death in the United States. Colonoscopy can reduce CRC incidence and deaths through removal of precancerous adenomatous polyps (adenomas) and detection of cancer at an earlier, more treatable stage. However, some patients develop CRC after a colonoscopy in which no cancer is diagnosed. The World Endoscopy Organization (WEO) defines post-colonoscopy colorectal cancers (PCCRCs) as CRC diagnosed 6 months after a colonoscopy that did not detect cancer. PCCRC is poorly understood as there is uncertainty about how often these cancers occur, their likely etiologies, the risk factors for these cancers, and whether they are more lethal than detected CRCs. To address these uncertainties, the WEO published a consensus statement to provide comprehensive guidance for the investigation of PCCRC cases. Their recommendations include a standardized definition for PCCRC, a defined method for calculating PCCRC rates, and standardized methods for performing qualitative reviews of cases to determine their likely etiology. The primary goal of the proposed study is to use recently published WEO methods to determine PCCRC rates, the likely etiologies for these cancers, their risk factors, and prognoses for PCCRC in the large integrated healthcare setting of Kaiser Permanente Northern California (KPNC).
Investigator: Lee, Jeffrey
Funder: Northern California Community Benefit Programs

De-Implementation of Outdated Colonoscopy Surveillance Interval Recommendations among Patients with Low-Risk Adenomas (DESIRE)

Recent guidelines have extended surveillance intervals for patients with low-risk adenomas from 5 years to 10. However, it remains unclear how to implement this change. In a pragmatic randomized 2-arm study of 1,000 patients with a history of low-risk adenomas and a standing 5-year surveillance recommendation, we will compare the effectiveness of secure messaging versus mailed outreach for adopting the new 10-year surveillance interval recommendation, continuing with the standing 5-year recommendation, or requesting a provider encounter (e.g., clinic or virtual visit) for shared decision making.
Investigator: Lee, Jeffrey
Funder: TPMG Delivery Science Projects Program

Optimizing Long-Term Post-Polypectomy Surveillance for Colorectal Cancer Prevention Using a Prediction Rule Developed from a Large, Community-Based Cohort

Screening has been shown to reduce colorectal cancer incidence and mortality. However, screening has resulted in a growing cohort of patients with adenomatous polyps (adenomas), and little is known about effectively managing their post-polypectomy surveillance. With limited data available in the literature to determine the appropriate timing and frequency of follow-up colonoscopy for patients after adenoma removal, recommendations for post-polypectomy surveillance from our national guidelines have been imprecise at best. To fill this knowledge gap, this project aims to: 1) determine the long- term colorectal cancer risk in patients after colonoscopic polypectomy in a very large “real world” community-based population; 2) identify patient-, polyp-, and exam-related risk factors associated with incident colorectal cancer in these patients; and 3) develop a risk prediction model that will identify post- polypectomy patients at high and low risk for developing subsequent colorectal cancer.
Investigator: Lee, Jeffrey
Funder: National Cancer Institute

Highlighted Publications

Effect of I-scan Electronic Chromoendoscopy on Detection of Adenomas During Colonoscopy.

Author(s): Kidambi, Trilokesh D TD; Terdiman, Jonathan P JP; El-Nachef, Najwa N; Singh, Aparajita A; Kattah, Michael G MG; Lee, Jeffrey K JK

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2018 Jun 20;():. Epub 2018-06-20.

Current Position(s):

Section Affiliations:

Studies

Rates and Risk Factors of Post-Colonoscopy Colorectal Cancer in a Large, United States Population-based Cohort Study

De-Implementation of Outdated Colonoscopy Surveillance Interval Recommendations among Patients with Low-Risk Adenomas (DESIRE)

Optimizing Long-Term Post-Polypectomy Surveillance for Colorectal Cancer Prevention Using a Prediction Rule Developed from a Large, Community-Based Cohort

Highlighted Publications

Effect of I-scan Electronic Chromoendoscopy on Detection of Adenomas During Colonoscopy.

Accurate Identification of Colonoscopy Quality and Polyp Findings Using Natural Language Processing

Accuracy of fecal immunochemical tests for colorectal cancer: systematic review and meta-analysis

Publications

Impact of the Affordable Care Act on Colorectal Cancer Incidence and Mortality

Endoscopic Surveillance and Dysplasia Management in IBD: Plus Ça Change, Plus C'est la Même Chose

Systematic review with meta-analysis: the prevalence of post-colonoscopy colorectal cancers using the World Endoscopy Organization nomenclature

Rising Early-Onset Colorectal Cancer Incidence is Not an Artifact of Increased Screening Colonoscopy Use in a Large, Diverse Healthcare System

Risk stratification for colorectal cancer in individuals with subtypes of serrated polyps

ASGE guideline on the role of endoscopy in the management of malignant hilar obstruction

ASGE guideline on the management of cholangitis

Simplifying ADR reporting - a worthy goal, but the devil is in the details

Sugary truth of early-onset colorectal neoplasia - not so sweet after all

Response to Li and Hopper

Validated training tools are needed for assessing competency in colorectal endoscopic mucosal resection

An update on the epidemiology, molecular characterization, diagnosis, and screening strategies for early-onset colorectal cancer

When Should We Let Colorectal Cancer Screening Get Personal?

ASGE guideline on the role of endoscopy in the management of benign and malignant gastroduodenal obstruction

Urban-Rural Disparities and Temporal Trends in Peptic Ulcer Disease Epidemiology, Treatment, and Outcomes in the United States

Influence of Telemedicine-First Intervention on Patient Visit Choice, Post-Visit Care, and Patient Satisfaction in Gastroenterology

Program components and results from an organized colorectal cancer screening program using annual fecal immunochemical testing

Genome-wide Modeling of Polygenic Risk Score in Colorectal Cancer Risk

Early Screening of African Americans (45-50 Years Old) in a Fecal Immunochemical Test-based Colorectal Cancer Screening Program

Primary Care Provider Beliefs and Recommendations About Colorectal Cancer Screening in Four Healthcare Systems

Role of Rare and Low-Frequency Variants in Gene-Alcohol Interactions on Plasma Lipid Levels

The effect of using fecal testing after a negative sigmoidoscopy on the risk of death from colorectal cancer

Increased Risk of Colorectal Cancer in Individuals With a History of Serrated Polyps

Proton Pump Inhibitor Use and Risk of Gastric, Colorectal, Liver, and Pancreatic Cancers in a Community-Based Population

American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in familial adenomatous polyposis syndromes

Impact of observational training on endoscopic mucosal resection outcomes and competency for large colorectal polyps: single endoscopist experience

ASGE guideline on minimum staffing requirements for the performance of GI endoscopy

Longitudinal Evolution of Markers of Mineral Metabolism in Patients With CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study

Morbidity and Mortality After Surgery for Nonmalignant Colorectal Polyps: A 10-Year Nationwide Analysis

Life Expectancy Disparities Among Adults With HIV in the United States and Canada: the Impact of a Reduction in Drug- and Alcohol-related Deaths Using the Lives Saved Simulation (LISSO) Model

Long-term Risk of Colorectal Cancer and Related Death After Adenoma Removal in a Large, Community-based Population.

Effect of Sex, Age and Positivity Threshold on Fecal Immunochemical Test Accuracy: a Systematic Review and Meta-Analysis

Colonoscopy Indication Algorithm Performance Across Diverse Health Care Systems in the PROSPR Consortium

ASGE guideline on the role of endoscopy for bleeding from chronic radiation proctopathy

Immunotherapy-Associated Pseudomembranous Colitis

Systematic review and meta-analysis: efficacy and safety of oral Janus kinase inhibitors for inflammatory bowel disease

A summary of the Fight Colorectal Cancer working meeting: exploring risk factors and etiology of sporadic early-age onset colorectal cancer

Low-Literacy Instructions Enable Successful Completion of Fecal Immunohistochemical Tests

Germline BRCA1 Deletion as Driver Mutation for Metastatic Urachal Adenocarcinoma in Patient Who Achieved Complete Response to Rucaparib

Strategies to Improve Follow-up After Positive Fecal Immunochemical Tests in a Community-Based Setting: A Mixed-Methods Study

Long-term Risk of Colorectal Cancer and Related Deaths After a Colonoscopy With Normal Findings

The Utility and Cross-Validation of a Composite Physical Activity Score in Relation to Cardiovascular Health Indicators: Coronary Artery Risk Development in Young Adults

Negative withdrawal time: simple and efficient

Colorectal Cancer Screening Participation Among Asian Americans Overall and Subgroups in an Integrated Health Care Setting with Organized Screening

Influence of Varying Quantitative Fecal Immunochemical Test Positivity Thresholds on Colorectal Cancer Detection: A Community-Based Cohort Study

Effects of Organized Colorectal Cancer Screening on Cancer Incidence and Mortality in a Large, Community-based Population.

Effect of I-scan Electronic Chromoendoscopy on Detection of Adenomas During Colonoscopy.

Novel variant of unknown significance in MUTYH in a patient with MUTYH-associated polyposis: a case to reclassify.

Yield of Colonoscopy After a Positive Result From a Fecal Immunochemical Test OC-Light.

Development and validation of the SIMPLE endoscopic classification of diminutive and small colorectal polyps.

An Unexpected Finding During Colonoscopy: Pinworms.

Interventions to Improve Follow-up of Positive Results on Fecal Blood Tests: A Systematic Review

Accurate Identification of Colonoscopy Quality and Polyp Findings Using Natural Language Processing

Endoscopy is of low yield in the identification of gastrointestinal neoplasia in patients with dermatomyositis: A cross-sectional study.

Surveillance for One or Two Small Adenomas: Low Risk Is Really Low Risk.

Association Between Time to Colonoscopy After a Positive Fecal Test Result and Risk of Colorectal Cancer and Cancer Stage at Diagnosis.

Recommendations on Fecal Immunochemical Testing to Screen for Colorectal Neoplasia: A Consensus Statement by the US Multi-Society Task Force on Colorectal Cancer.

Fecal Immunochemical Test Program Performance Over 4 Rounds of Annual Screening: A Retrospective Cohort Study

What makes a "good" colonoscopy quality indicator?

Factors Influencing Variation in Physician Adenoma Detection Rates; a Theory-Based Approach for Performance Improvement

Development and validation of an algorithm for classifying colonoscopy indication

Importance of determining indication for colonoscopy: implications for practice and policy original

Adjusting for Patient Demographics Has Minimal Effects on Rates of Adenoma Detection in a Large, Community-based Setting

Multitarget stool DNA testing for colorectal-cancer screening.

Adenoma detection rate and risk of colorectal cancer and death

Accuracy of fecal immunochemical tests for colorectal cancer: systematic review and meta-analysis

Recurrence of subsquamous dysplasia and carcinoma after successful endoscopic and radiofrequency ablation therapy for dysplastic Barrett's esophagus.

The road ahead: what if gastroenterologists were accountable for preventing colorectal cancer?

Association between serum interleukin-6 concentrations and mortality in older adults: the Rancho Bernardo study.