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Chapter 16: Modeling Cancer Natural History, Epidemiology, and Control: Reflections on the CISNET Breast Group Experience
Affiliations of authors: Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands (JDFH); Albert Einstein School of Medicine, New York, NY (CBS); Statistical Research and Application Branch, Division of Cancer Control and Population Science, National Cancer Institute, Bethesda, MD (KAC, EJF); Cornerstone Systems Northwest Inc., Lynden, WA (LDC)
Correspondence to: J. Dik F. Habbema, PhD, Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands (e-mail: j.d.f.habbema@erasmusmc.nl).
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INTRODUCTION |
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This chapter will discuss the work of the cancer intervention and surveillance modeling network (CISNET) breast group. The discussion is structured around questions concerning the aims, results, process, and implications of the breast group experience.
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WHAT WAS THE AIM? |
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The general aim of CISNET is modeling the impact of cancer control interventions on population trends in incidence and mortality for breast, prostate, colorectal, and lung cancer. The seven breast cancer investigations collaborated on answering the main question, "What is the impact of adjuvant therapy and screening mammography on U.S. breast cancer mortality: 1975–2000?" (1). It took 4 years of effort in model building and validation, input preparation and calibration, and producing and interpreting the results to answer the main question.
We start with discussing the formulation of the main question. Apart from adjuvant therapy and screening there have been other less conspicuous developments in treatment. These are the many small incremental
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WHAT IS THE MAIN RESULT? |
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HOW SHOULD THE MAIN RESULT BE COMMUNICATED? |
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WHAT HAS BEEN ACHIEVED, APART FROM THE MAIN RESULT? |
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HOW WERE THE RESULTS OBTAINED? |
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WHAT HAS BEEN THE ROLE OF THE COMMON INPUT IN THE RESULTS? |
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WHY THE DIFFERENCES IN RESULTS BETWEEN THE MODELS? |
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WHAT IS SPECIAL ABOUT BREAST CANCER? |
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WHAT ARE THE IMPLICATIONS FOR MODEL RESEARCH? |
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MAKING UP THE BALANCE |
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CONCLUSION |
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