Modeling Effective Health Policies for Colorectal Cancer

描述(申请人提供)：结直肠癌(CRC)仍然是美国癌症死亡的第二大常见原因，尽管有一系列干预措施可以减轻CRC的负担。微模拟建模可以让政策制定者在这些癌症控制干预措施中确定优先顺序。CISNET-CRC团队包括三个协作建模小组，每个小组都有一个最先进的、基于种群的CRC微观仿真模型：MISCAN、SimCRC和CRC-SPIN。这三个建模小组已经合作了八年，并提供了大量以政策为导向的工作。我们建议继续这种合作，进一步开发我们的模型，并使用它们来确定最佳的癌症控制政策和实践，以减轻CRC的负担。 我们提议的工作围绕三个具体目标展开。在目标1中，我们扩展了我们的模型，以反映对结直肠癌疾病过程的不断发展的理解，并纳入新的和更新的筛查模式，使我们能够解决新的政策问题。在这里，我们关注关于基因组学、生物标记物、通路的新数据，以及即将到来的柔性乙状结肠镜筛查随机对照试验的数据。在目标2中，我们应用我们最新的模型来为卫生政策提供信息，包括评估整个癌症控制范围内的干预措施。将对新技术和更多针对个人定制的筛查和治疗战略进行评估，特别关注健康差距。在目标3中，我们通过让政策制定者参与并鼓励在政策制定和决策支持中适当使用建模的方法，传播我们的模型的结果，为卫生政策提供信息。在这里，我们设想使用开放访问的基于网络的模型应用程序进行创新。我们将从特定应用程序所需的模型扩展开始，在整个资金期内，工作的平衡将严重转向应用程序。我们的调查结果将在整个筹资期间进行传播。

DESCRIPTION (provided by applicant): Colorectal cancer (CRC) is still the second most common cause of cancer death in the United States, despite the availability of a range of interventions to reduce the burden of CRC. Microsimulation modeling can inform policy makers in prioritizing among these cancer-control interventions. The CISNET-CRC team includes three collaborative modeling groups, each with a state-of-the-art, population-based microsimulation model for CRC: MISCAN, SimCRC, and CRC-SPIN. These three modeling groups have collaborated for eight years and have delivered a substantial body of policy-oriented work. We propose to continue this collaboration, further developing our models and using them to identify optimal cancer-control policies and practices to reduce the burden of CRC. Our proposed work centers around three specific aims. In Aim 1 we extend our models to reflect the evolving understanding of the CRC disease processes and to incorporate new and updated screening modalities, allowing us to address new policy questions. Here we focus on new data on genomics, biomarkers, pathways, and the upcoming data from randomized controlled trials of flexible sigmoidoscopy screening. In Aim 2 we apply our updated models to inform health policy, including evaluation of interventions across the cancer-control spectrum. New technologies and more individually tailored screening and treatment strategies will be evaluated with a special focus on health disparities. In Aim 3 we disseminate results from our models to inform health policy, via methods that engage policy makers and encourage appropriate use of modeling in policy making and decision support. Here we envision innovation using open-access web-based model applications. We will begin with model extensions required for specific applications, with the balance of the work shifting heavily toward applications over the course of the funding period. Dissemination of our findings will occur throughout the funding period.