Comparative Modeling to Inform Cervical Cancer Control Policies

 描述（由申请人提供）：尽管在美国成功进行了宫颈癌筛查，但每年仍有超过12，000名妇女患上宫颈癌，4，000名妇女死于宫颈癌。新技术，包括针对人乳头瘤病毒（HPV）（一种已知会导致宫颈癌的性传播病毒）的筛查测试和疫苗，为美国的创新和有效的宫颈癌计划提供了巨大的机会，但也为决策带来了重大挑战，因为疾病的自然史复杂而漫长，以及干预措施应用于疾病谱的不同时间点沿着。因此，政策制定者唯一依赖于数学建模，以提供最佳宫颈癌控制策略的证据。这些模型可用于整合最新数据，将当前的短期发现外推到长期结果中，并评估在临床研究中不切实际或不可行的假设情景。有越来越多的独立的数学模型已经开发出来，以解决有关宫颈癌预防和控制的临床和政策问题，但没有正式的努力来比较模型之间的假设和结果。作为CISNET联盟的一部分，一组来自美国的宫颈癌建模者，澳大利亚和荷兰将进行正式的比较建模合作，使用一系列最先进的HPV和宫颈癌发生的数学模型。我们将继续分析筛查的历史影响，当前和预期的HPV疫苗接种和筛查策略的比较有效性，以及减少宫颈癌差异的最佳途径。

 DESCRIPTION (provided by applicant): Despite successful cervical cancer screening in the United States, over 12,000 women develop and 4,000 women die from cervical cancer each year. New technologies, including screening tests and vaccines against human papillomavirus (HPV), a sexually-transmitted virus known to cause cervical cancer, represent tremendous opportunities for innovative and efficient cervical cancer programs in the U.S. but also pose significant challenges for decision making, due to the complex and long natural history of disease and the different time points along the disease spectrum at which interventions are applied. Consequently, policy makers are uniquely reliant on mathematical modeling to provide evidence on the optimal cervical cancer control strategies. These models can be used to integrate the most up-to-date data, extrapolate current short- term findings into long-term outcomes, and evaluate what-if scenarios that would otherwise be impractical or infeasible to conduct in clinical studies. There has been a growing number of independent mathematical models that have been developed to address clinical and policy questions with respect to cervical cancer prevention and control but no formal efforts to compare assumptions and results across models. As part of the CISNET consortium, a group of established cervical cancer modelers from the U.S., Australia, and the Netherlands will engage in a formal collaboration of comparative modeling using a series of state-of-the-art mathematical models of HPV and cervical carcinogenesis. We will pursue analyses related to the historical impact of screening, the comparative effectiveness of current and anticipated HPV vaccination and screening strategies, and optimal routes for reducing cervical cancer disparities.