An Updated Natural History Model of Cervical Cancer: Derivation of Model Parameters
An Updated Natural History Model of Cervical Cancer: Derivation of Model Parameters
复制标题
DOI：
10.1093/aje/kwu159
复制
发表时间：
2014-09-01
影响因子：
5
通讯作者：
Kim, Jane J.
中科院分区：
文献类型：
--
作者：
Campos, Nicole G.;Burger, Emily A.;Kim, Jane J.
宫颈癌的数学模型已被广泛用于评估预防策略的相对有效性和成本效益。对宫颈癌发生的理解的重大进展促使在此类模型中创建新的疾病范例。为了跟上最新证据的步伐，我们更新了先前开发的人乳头瘤病毒（HPV）感染和宫颈癌的微观模拟模型，以反映1）基于HPV而不是可重复性差的组织学诊断的健康状态转变，以及2）HPV清除和癌前病变进展作为感染持续时间和基因型的函数，来源于哥斯达黎加疫苗试验（2004-2010）的对照组。该模型利用来自新墨西哥州监测、流行病学和最终结果登记处（1980-1999年）和新墨西哥州最先进的宫颈癌筛查登记处（2007-2009年）的经验数据进行校准。校准模型与基因型和年龄特异性HPV患病率、癌前和癌症中的基因型频率以及年龄特异性癌症发病率数据具有良好的对应性。我们提出这一模型，以响应一个新的自然历史模型的子宫颈癌的决策分析和经济评估的时候，全球子宫颈癌预防政策不断发展和子宫颈干预措施的长期健康影响的证据仍然是至关重要的。
Mathematical models of cervical cancer have been widely used to evaluate the comparative effectiveness and cost-effectiveness of preventive strategies. Major advances in the understanding of cervical carcinogenesis motivate the creation of a new disease paradigm in such models. To keep pace with the most recent evidence, we updated a previously developed microsimulation model of human papillomavirus (HPV) infection and cervical cancer to reflect 1) a shift towards health states based on HPV rather than poorly reproducible histological diagnoses and 2) HPV clearance and progression to precancer as a function of infection duration and genotype, as derived from the control arm of the Costa Rica Vaccine Trial (2004-2010). The model was calibrated leveraging empirical data from the New Mexico Surveillance, Epidemiology, and End Results Registry (1980-1999) and a state-of-the-art cervical cancer screening registry in New Mexico (2007-2009). The calibrated model had good correspondence with data on genotype-and age-specific HPV prevalence, genotype frequency in precancer and cancer, and age-specific cancer incidence. We present this model in response to a call for new natural history models of cervical cancer intended for decision analysis and economic evaluation at a time when global cervical cancer prevention policy continues to evolve and evidence of the long-term health effects of cervical interventions remains critical.