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，用于评估结直肠癌（CRC）发病率和死亡率的国家趋势。HSPH-CISNET模型结合了CRC风险因素、筛查和治疗的年龄、性别和种族特异性趋势，以及风险因素和筛查对结直肠疾病基础自然史的影响和诊断为CRC患者的治疗有效性。该模型目前模拟了1970年至2020年25岁及以上的美国人口。我们使用该模型来研究风险因素、筛查和治疗变化对CRC发病率和死亡率总体人群趋势的相对贡献。 本项目的目的是使用HSPH-CISNET模型来评估现有癌症控制策略对人口的影响，以及未来策略的影响。特别重要的是要纳入风险因素和筛查趋势之间的关联，并确定在人群水平上CRC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群水平的影响。 为了验证我们的建模假设，我们将使用我们的模型结构来模拟挪威的人口，这个国家没有CRC筛查计划，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组以及新的CRC协调中心和NCI合作，专注于所有建模组都适用的问题。此外，我们提出了一个具体的计划，使我们的模型更容易接触到外部合作者。该计划包括在公共网站上发布模型结构，与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.