Disparities in Cancer Prevention and Control

癌症预防和控制方面的差异

• 批准号: 7149001
• 负责人: KAREN M KUNTZ
• 金额: $ 1.22万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2006-10-08
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7149001
• 关键词: African American; behavioral /social science research tag; breast neoplasms; cancer prevention; caucasian American; cervix neoplasms; clinical research; colorectal neoplasms; computer simulation; cost effectiveness; health care model; health disparity; health services research tag; human data; mass screening; neoplasm /cancer diagnosis; neoplasm /cancer therapy; women' s health

DESCRIPTION (PROVIDED BY APPLICANT): The purpose of this project is to extend our current work on the development of decision-analytic policy models in cancer to quantify the impact of disparities in screening, follow-up, and treatment in terms of its impact on cancer-related outcomes. We will initially develop a generalizable model that will serve as a framework for incorporating disparities in decision-analytic models. We will focus on disparities in cancer risk, cancer screening participation rates, treatment patterns, and their interactions. We will evaluate several hypothetical situations to highlight those areas where disparities are most concerning. In addition, we will leverage the work that we have already done to develop cohort-specific simulation models to address socially relevant policy questions that disproportionately affect certain segments of the population. We will conduct analyses for questions pertaining to three major cancers: colorectal, cervical and breast. The models will be evaluated as Monte Carlo simulations (one person at a time), which provide a substantial amount of flexibility in terms of keeping track of person-specific variables. The colorectal cancer and cervical cancer models simulate the evolution from a normal cervix or normal colonic epithelium to precancerous lesions (i.e., adenomatous polyps for the former model, cervical lesions for the latter) to malignancy. Cancer diagnosis occurs when a screening test is applied to a person with undiagnosed malignancy (based on the test sensitivity), or if symptoms occur that lead to a correct diagnosis (symptom-diagnosed cancer). Once a cancer is detected and staged, details of specific treatment strategies can be incorporated that affect cancer-specific mortality. The cancer-specific models will be used to analyze the effects of important contributors to disparities and how they relate to cancer control.

描述（由申请人提供）：该项目的目的是扩展我们目前在癌症决策分析政策模型开发的工作，以量化差异在筛查，随访和治疗方面的影响，以其对癌症相关结果的影响。我们最初将开发一个可推广的模型，该模型将作为将差异纳入决策分析模型的框架。我们将专注于癌症风险的差异，癌症筛查参与率，治疗模式及其相互作用。我们将评估几种假设的情况，以突出那些最关注差异的领域。此外，我们将利用我们已经为开发特定于同类的模拟模型所做的工作来解决与社会相关的政策问题，这些问题不成比例地影响人群的某些部分。 我们将对与三种主要癌症有关的问题进行分析：结直肠，颈椎和乳房。 这些模型将被评估为蒙特卡洛模拟（一次一个人），该模拟在跟踪特定于人的变量方面提供了很大的灵活性。结直肠癌和宫颈癌模型模拟了从正常子宫颈或正常结肠上皮到癌前病变的演变（即，前者的腺瘤息肉，后者的宫颈病变）到恶性肿瘤。当将筛查测试应用于未诊断的恶性肿瘤（基于测试敏感性）时，或者发生症状导致正确诊断（症状诊断癌症）时，就会发生癌症诊断。一旦发现并上演了癌症，就可以纳入影响特定癌症死亡率的特定治疗策略的细节。癌症特异性模型将用于分析重要的贡献者对差异的影响及其与癌症控制的关系。