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方面的工作，以量化筛查、随访和治疗方面的差异对癌症的影响。癌症相关的结果。我们最初将开发一个可推广的模型，作为将差异纳入决策分析模型的框架。我们将重点关注癌症风险、癌症筛查参与率、治疗模式及其相互作用的差异。我们将评估几种假设情况，以突出显示差异最令人担忧的领域。此外，我们将利用已经完成的工作来开发针对特定群体的模拟模型，以解决对某些人群产生不成比例影响的社会相关政策问题。 我们将对与三种主要癌症：结直肠癌、宫颈癌和乳腺癌有关的问题进行分析。 这些模型将作为蒙特卡罗模拟（一次一个人）进行评估，这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从正常子宫颈或正常结肠上皮到癌前病变（即前者模型为腺瘤性息肉，后者为宫颈病变）到恶性肿瘤的演变。当对患有未确诊恶性肿瘤（基于测试敏感性）的人进行筛查测试时，或者如果出现导致正确诊断的症状（症状诊断为癌症）时，就会发生癌症诊断。一旦癌症被检测到并进行分期，就可以纳入影响癌症特异性死亡率的具体治疗策略的细节。癌症特异性模型将用于分析造成差异的重要因素的影响以及它们与癌症控制的关系。