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泌尿生殖系统恶性肿瘤，大约有每年有 80,000 例新病例和 17,700 例死亡。这是一组异质性疾病，范围从可局部治疗的浅表肿瘤通常不会危及生命，但需要长期治疗，需要多模式侵入性治疗且远端转移风险较高的晚期疾病它是美国第九大最昂贵的癌症，也是每名确诊患者中最昂贵的癌症。膀胱癌的危险因素广泛包括化学和环境。暴露，例如吸烟和摄入或在环境中发现的化学致癌物质工作场所，以及遗传异常和慢性膀胱刺激的结果。过去二十年保持相对稳定，但改善的机会很多。膀胱癌的预防、检测和治疗。治疗，包括免疫疗法（检查点抑制剂）、基因疗法和抗体药物结合物可能在未来几年产生巨大影响，并且适合人群建模。因为它具有很高的发病率、死亡率和成本，可以通过尽量减少吸烟和毒素来预防暴露以及新型有前景的生物标志物和治疗方法的出现是我们的长期目标。研究计划旨在提高人口和个人层面的有效性和效率鉴于当前的知识和经验，膀胱癌预防、检测和管理的方法当前提案的总体目标是解决监测中的主要问题，通过比较数学模型治疗、预防和诊断膀胱癌。我们将实现六个具体目标：我们将 (1) 完成开发、校准和验证 (2)解释膀胱癌的长期趋势发病率与关键人群亚群体烟草使用趋势的关系，并估计该事件的影响 1964 年卫生局局长的吸烟建议；(3) 评估戒烟的有效性，预防膀胱癌发病率和死亡率的减少和预防干预措施 (4) 评估通用和定制/以患者为中心的监测政策的有效性和成本效益对于非肌层浸润性膀胱癌患者；（5）评估以下方法的比较有效性：器官局限性膀胱癌的治疗；(6) 评估膀胱筛查的有效性高风险亚群中的癌症。