Population Modeling of Bladder Cancer Detection and Control

膀胱癌检测和控制的群体建模

基本信息

批准号：
10693967
负责人：
Hawre Jalal
金额：
$ 65.36万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-13 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10693967
关键词：
Address Age Antibody-drug conjugates BCG Live Biological Markers Bladder Calibration Cancer Control Cancer Detection Cancer Etiology Carcinogens Cessation of life Chemical Exposure Chronic Colorectal Cancer Cystoscopy Detection Development Diagnosis Disease Distal Effectiveness Environmental Exposure Genitourinary system Goals Health Policy Immune checkpoint inhibitor Immunotherapy Incidence Ingestion Knowledge Malignant Neoplasms Malignant neoplasm of lung Malignant neoplasm of prostate Malignant neoplasm of urinary bladder Mathematics Modality Modeling Molecular Abnormality Morbidity - disease rate Natural History Nature Neoplasm Metastasis Organ Outcome Patients Persons Policies Population Prevention Production Public Health Recommendation Recurrence Research Risk Risk Factors Schedule Screening for cancer Smoking Smoking History Subgroup Surgeon Testing Time trend Tobacco use Toxin Treatment Effectiveness Uncertainty Validation Woman Workplace advanced disease biomarker driven bladder cancer prevention cancer care chemical carcinogen chemotherapy chronic bladder irritation cigarette smoking comparative comparative effectiveness cost cost effectiveness cost estimate effectiveness evaluation gene therapy high risk improved insight intravesical malignant breast neoplasm mathematical model men modifiable risk mortality multimodality muscle invasive bladder cancer non-muscle invasive bladder cancer novel novel marker older men predictive tools preservation prevent preventive intervention programs screening simulation smoking cessation smoking exposure smoking prevalence surveillance strategy trend tumor

项目摘要

Abstract Bladder cancer is the second most common genitourinary malignancy in the US with approximately 80,000 new cases and 17,700 deaths each year. It is a heterogeneous set of diseases that range from locally treatable superficial tumors that are generally not life-threatening but require chronic management, to advanced disease that requires multimodal invasive treatments and has higher risk of distal metastasis and death. It is the ninth most expensive cancer overall in the US, and, per diagnosed patient, the most expensive cancer to manage. Risk factors for bladder cancer broadly include chemical and environmental exposures such as cigarette smoking and chemical carcinogens that are ingested or found in the workplace, as well as genetic abnormalities and chronic bladder irritation. Outcomes for bladder cancer have remained relatively stable in the last two decades. However, opportunities abound to improve the prevention, detection, and management of bladder cancer. The advent of novel biomarkers, and novel treatments, including immunotherapies (checkpoint inhibitors), gene therapies, and antibody-drug conjugates may have a large impact in coming years. Bladder cancer is amenable to population modeling because it has high morbidity, mortality, and cost, is likely preventable by minimizing smoking and toxin exposure, and the emergence of novel promising biomarkers and treatments. The long-term goal of our research program is to improve the effectiveness and efficiency of population- and person-level approaches to bladder cancer prevention, detection, and management given current knowledge and constraints. The overall objective of the current proposal is to address major questions in the surveillance, treatment, prevention, and diagnosis of bladder cancer by means of comparative mathematical modeling. We will address six specific aims: We will (1) complete the development, calibration, and validation of two independent population models of bladder cancer; (2) explain secular trends in bladder cancer incidence in relation to trends in tobacco use in key population subgroups and estimate the impact of the 1964 Surgeon General’s smoking recommendations; (3) assess the effectiveness of smoking cessation, reduction and prevention interventions for the prevention of bladder cancer incidence and mortality; (4) assess the effectiveness and cost-effectiveness of generic and tailored/patient-centric surveillance policies for patients with non-muscle invasive bladder cancer; (5) assess the comparative effectiveness of treatments for organ-confined bladder cancer; and (6) assess the effectiveness of screening for bladder cancer among high-risk subgroups.

抽象的膀胱癌是美国第二常见的生殖性恶性肿瘤，大约每年80,000例新病例和17,700例死亡。这是一组来自通常不威胁生命但需要慢性管理的本地可治疗的浅表肿瘤，对于需要多模式侵入性治疗并且远端转移风险较高的晚期疾病和死亡。这是美国第九最昂贵的癌症，根据诊断患者，这是最昂贵的癌症昂贵的癌症要管理。膀胱癌的危险因素广泛包括化学和环境在摄入或发现的诸如吸烟和化学致癌物之类的暴露量工作场所，遗传异常和慢性膀胱刺激。膀胱癌的结果在过去的二十年中，保持相对稳定。但是，有机会改善膀胱癌的预防，检测和管理。小说生物标志物和小说的冒险治疗，包括免疫疗法（检查点抑制剂），基因疗法和抗体 - 药物在未来几年中，缀合物可能会产生很大的影响。膀胱癌可与人群建模因为它具有高发病率，死亡率和成本，因此可以通过最小化吸烟和毒素来预防暴露，以及新颖有希望的生物标志物和治疗的出现。我们的长期目标研究计划是为了提高人口和人级的有效性和效率鉴于当前的知识和约束。当前提案的总体目的是解决监视中的主要问题，通过比较数学建模对膀胱癌的治疗，预防和诊断。我们将解决六个具体目标：我们将（1）完成开发，校准和验证两种独立的膀胱癌人群模型；（2）解释膀胱癌的安全趋势与关键人群亚组中烟草使用趋势有关的发病率，并估计 1964年外科医生的吸烟建议；（3）评估戒烟的有效性，减少和预防预防膀胱癌发病率和死亡率的干预措施；（4）评估通用和量身定制/以患者为中心的监视政策的有效性和成本效益对于非肌肉侵入性膀胱癌的患者；（5）评估比较有效性器官覆盖的膀胱癌的治疗；（6）评估膀胱筛查的有效性高风险亚组中的癌症。