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Chapter 7: The Wisconsin Breast Cancer Epidemiology Simulation Model
Affiliations of authors: Departments of Population Health Sciences (DGF, NKS, ATD, PLR), Actuarial Science, Risk Management, and Insurance (MAR), Biostatistics Medical Informatics (MAR), and Industrial and Systems Engineering (DGF, VK), University of Wisconsin, Madison, WI; University of Wisconsin Comprehensive Cancer Center, Madison, WI (ATD, PLR)
Correspondence to: Dennis G. Fryback, PhD, Department of Population Health Sciences, University of Wisconsin–Madison, 610 Walnut St., Rm. 685, Madison, WI 53726 (e-mail: dfryback{at}wisc.edu).
The Wisconsin Breast Cancer Epidemiology Simulation Model is a discrete-event, stochastic simulation model using a systems-science modeling approach to replicate breast cancer incidence and mortality in the U.S. population from 1975 to 2000. Four interacting processes are modeled over time: (1) natural history of breast cancer, (2) breast cancer detection, (3) breast cancer treatment, and (4) competing cause mortality. These components form a complex interacting system simulating the lives of 2.95 million women (approximately 1/50 the U.S. population) from 1950 to 2000 in 6-month cycles. After a "burn in" of 25 years to stabilize prevalent occult cancers, the model outputs age-specific incidence rates by stage and age-specific mortality rates from 1975 to 2000. The model simulates occult as well as detected disease at the individual level and can be used to address "What if?" questions about effectiveness of screening and treatment protocols, as well as to estimate benefits to women of specific ages and screening histories.
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