A Population Based Policy Model for Colorectal Cancer

描述(由申请人提供)： 在第一个CISNet项目中，我们开发了一个基于人群的蒙特卡罗模拟模型，用于评估全国结直肠癌(CRC)发病率和死亡率的趋势。HSPH-CISNET模型结合了年龄、性别和种族在结直肠癌危险因素、筛查和治疗方面的特定趋势，以及危险因素和筛查对结直肠癌潜在自然病史和确诊结直肠癌患者治疗效果的影响。该模型目前模拟了1970年至2020年25岁及以上的美国人口。我们使用该模型检验了危险因素、筛查和治疗的变化对结直肠癌发病率和死亡率总体人口趋势的相对贡献。 该项目的目的是使用HSPH-CISNET模型来评估现有癌症控制战略对人口的影响，以及即将实施的战略的影响。尤其重要的是纳入风险因素和筛查趋势之间的联系，并在人口层面上确定结直肠癌风险和死亡率差异的潜在影响。其他目标将侧重于评估特定风险因素趋势、筛查方式和治疗进展对人口层面的影响。为了验证我们的建模假设，我们将使用我们的模型结构模拟挪威的人口，挪威是一个没有CRC筛查计划的国家，试图重新创建他们的发病率和死亡率统计数据。我们将继续与其他建模小组以及新的CRC协调中心和NCI合作，专注于适用于所有建模小组的问题。此外，我们提出了一个具体的计划，使我们的模型更容易为外部合作者所访问。该计划包括将模型结构张贴在公共网站上，与既定的外部调查人员共享代码，并提供必要的模型支持。

DESCRIPTION (provided by applicant): In the first CISNET project we developed a population-based Monte Carlo simulation model that evaluates national trends in the incidence and mortality of colorectal cancer (CRC). The HSPH-CISNET Model incorporates age-, sex-, and race-specific trends in CRC risk factors, screening, and treatment, as well as the effects of risk factors and screening on the underlying natural history of colorectal disease and the effectiveness of treatment for patients with diagnosed CRC. The Model currently simulates the US population aged 25 years and older from 1970 to 2020. We have used the Model to examine the relative contribution of changes in risk factors, screening, and treatment to the overall population trends in CRC incidence and mortality. The purpose of this project is to use the HSPH-CISNET Model to evaluate the population impact of existing cancer control strategies, as well as the impact of strategies on the horizon. Of particular importance is to incorporate the associations between risk factors and screening trends, and to determine the potential impact of disparities in CRC risk and mortality at a population level. Other aims will focus on evaluating the population-level impact of specific risk factor trends, screening modalities, and treatment advancements. To validate our modeling assumptions, we will use our model structure to simulate the population of Norway, a country that does not have a CRC screening program, in an attempt to re-create their incidence and mortality statistics. We will continue to collaborate with other modeling groups, as well as with the new CRC Coordinating Center and the NCI to focus on questions that apply across all modeling groups. In addition, we propose a concrete plan for making our model more accessible to outside collaborators. This plan involves posting the model structure on a public website, sharing code with established outside investigators, and providing the necessary model support.