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JNCI Monographs 2006 2006(36):56-65; doi:10.1093/jncimonographs/lgj009
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© The Author 2006. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org.

Chapter 9: The MISCAN-Fadia Continuous Tumor Growth Model for Breast Cancer

Sita Y. G. L. Tan, Gerrit J. van Oortmarssen, Harry J. de Koning, Rob Boer, J. Dik F. Habbema

Affiliation of authors: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands

Correspondence to: J. Dik F. Habbema, PhD, Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands (e-mail:j.d.f.habbema{at}erasmusmc.nl).

The MISCAN-Fadia model was used to analyze the impact of screening and adjuvant treatment on U.S. breast cancer mortality between 1975 and 2000. MISCAN-Fadia uses the concept of "fatal diameter" to model survival and screening benefit and is based on continuous tumor growth. It consists of four major components: population, natural history, screening, and treatment. Population parameters were quantified using U.S. population data. Most natural history and screening parameters were fitted to the Swedish Two County screening trial data; some were based on Surveillance, Epidemiology, and End Results data. Adjuvant treatment parameters were quantified using data from the Early Breast Cancer Trialists' Collaborative Group's meta-analysis. The simulated trend in incidence matches the observed trend reasonably well; the simulated mortality is equal to the observed in 1975 but becomes increasingly too high in 2000. We estimate that screening leads to a 15% and adjuvant treatment to a 21% mortality reduction in the year 2000.


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