Comparative Modeling to Inform Cervical Cancer Control Policies

比较模型为宫颈癌控制政策提供信息

基本信息

批准号：
10440186
负责人：
Ruanne Vanessa Barnabas
金额：
$ 7.58万
依托单位：
HARVARD SCHOOL OF PUBLIC HEALTH
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-08 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10440186
关键词：
Address Administrative Supplement Adolescent Aftercare Automobile Driving Biological Factors Calibration Cancer Burden Cancer Control Cancer Intervention and Surveillance Modeling Network Cancer Model Categories Cervical Cervical Cancer Screening Collaborations Continuity of Patient Care Data Data Analytics Diagnosis Diagnostic tests Distant Epidemiology Evaluation Exercise Extravasation Failure Future General Population Genetic Genetic Markers High Prevalence Human Papilloma Virus Vaccination Human Papilloma Virus Vaccine Human Papillomavirus Hysterectomy Incidence Individual Influentials Intention Intervention Lead Malignant Neoplasms Malignant neoplasm of cervix uteri Methods Modeling Natural History Odds Ratio Pathway interactions Pattern Policies Population Prevalence Prevention Race Risk Factors Role Series Site Testing Treatment Failure United States Update Vaccination Validation Variant Woman Work base black women burden of illness cancer care cancer health disparity cancer site cancer therapy cervical cancer prevention cervical carcinogenesis comparative data sharing health disparity high risk improved laboratory experiment mortality non-compliance racial disparity screening uptake virtual laboratory working group

项目摘要

Project Summary/Abstract Advances in cervical cancer prevention and treatment have resulted in substantial reductions in incidence and mortality in the United States (US) over the past twenty years. However, even as overall rates improve, Black women remain at higher risk than White women for cervical cancer incidence, diagnosis at distant stage, and mortality. Reasons for these persistent disparities are multifactorial, likely resulting from additive failures along the cancer care continuum, including increased prevalence of predisposing risk factors, lower receipt of recommended cervical cancer screening, and delays in receipt of treatment after abnormalities are diagnosed. To make progress in improving cancer care equity, it is essential to delineate the determinants of racial disparities in cervical cancer incidence and mortality as a first step towards identifying feasible, effective, and high-value interventions. We propose to adapt the Harvard Chan’s cervical cancer model current default “all race” (i.e., population average) to reflect variations in the disease burden, as well as both screening and vaccination practice patterns, among Black women in the US. We will adapt an all-race cervical cancer model by updating key demographic input parameters to reflect Black women in the US, such as all-cause mortality and hysterectomy rates. We then will perform analyses using our Black-specific cervical cancer model to identify the main contributors to disparities in cervical cancer incidence and mortality. Specifically, we will start by changing the values in each of the main categories of parameters (i.e., natural history, screening practice patterns, treatment patterns) sequentially from the all-race values to the Black-specific calibrated values to understand how influential each block of parameters is in explaining the differences in incidence and mortality. Finally, we will use the adapted model to examine the potential for interventions to alleviate cervical cancer disparities. This work, led by the Harvard modeling site, will lay the groundwork for comparative modeling across the other four CISNET-Cervical modeling sites, as well as enable collaboration across the other CISNET cancer sites in identifying strategies to reduce overall cancer disparities among Black individuals in the US population.

项目摘要/摘要宫颈癌预防和治疗的进步导致发病率大幅降低和在过去的二十年中，美国（美国）的死亡率。但是，即使总体利率提高，黑色妇女在宫颈癌事件，远处诊断和死亡。这些持续差异的原因是多因素，可能是由于添加剂失败而引起的癌症护理连续体，包括增加易感风险因素的患病率，较低的收到诊断出异常后，建议的宫颈癌筛查和接收治疗的延迟。为了改善癌症护理公平的进步，必须描述确定种族宫颈癌发病率和死亡率的差异是确定可行，有效和高价值干预措施。我们建议适应哈佛大学的宫颈癌模型当前默认默认默认“所有种族”（即人口平均）反映伯恩疾病的变化，以及筛查和疫苗接种练习模式，在美国的黑人妇女中。我们将通过更新关键的人口统计输入参数来调整全赛宫颈癌模型以反映黑色美国的妇女，例如全因死亡率和子宫切除术率。然后，我们将使用我们的黑色特异性宫颈癌模型，以识别宫颈癌发生差异的主要因素和死亡率。具体来说，我们将首先更改参数的每个主要类别中的值（即自然历史，筛选练习模式，治疗模式）从全赛值到黑色特异性校准值，以了解每个参数的影响发病率和死亡率的差异。最后，我们将使用改编的模型来检查减轻宫颈癌差异的干预措施。这项由哈佛建模地点领导的工作将为跨另一个的比较建模奠定基础四个CISNET宫颈建模地点，以及在其他Cisnet癌症场所进行协作确定减少美国黑人人群中癌症分布的策略。