The main goal of our proposed research is to quantify the impact of screeningand treatment interventionson breast cancer incidenceand mortality trends in the United States through a collaborative research agreement with the NCIs Cancer Intervention and Surveillance Modeling Network (CISNET). Under our original CISNET award, we quantified the relativecontributionsof screening mammography and multiagent chemotherapy to the recent decline in breast cancer mortality. In this application, we are proposing to extend our analysis of the current breast cancer trends to include the impact of screen-detected DCIS. We will also identify the component of current trends in breast cancer incidence and mortality attributableto the subpopulation at high genetic risk for developingthe disease. In additionto studying the current trends more closely, we will extend the use of our model to the study of future trends. Through a CISNET/DHHS supplemental award, we have already performed a pilot study on the use of our model in determining whether or not the Healthy People 2010 goals in breast cancer mortalitycould be achieved. This project revealed the need to enhance our existing CISNET model so that it could take as inputs intermediate endpointsfrom screening and treatment trials. More often than not the performance of medical innovations are being evaluated on short term endpoints or surrogate markers. New treatment protocols are now being broadly adopted on the basis of lowered recurrence rates, with little knowledge of their impact on survival. New screening technologies are being advocated on the basis of increased detection rates, with little knowledgeof their impact on survival. We want to extrapolate the intermediate endpoints of breast cancer trials in screening and treatment to long term survival endpoints and then translate these findings to the population level. We will focus a part of our efforts on the study of new screening technologies in the high risk population in order to better understand how these interventions can be translated to the general population.We will make our CISNET model availablefor broader publicconsumption and welcome pressing questions from policy makers during the course of our study.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01CA088248-08
Application #
7500031
Study Section
Special Emphasis Panel (ZCA1-SRRB-K (M1))
Program Officer
Cronin, Kathleen A
Project Start
2000-09-01
Project End
2010-08-31
Budget Start
2008-09-01
Budget End
2009-08-31
Support Year
8
Fiscal Year
2008
Total Cost
$268,644
Indirect Cost
Name
Stanford University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
Alagoz, Oguzhan; Berry, Donald A; de Koning, Harry J et al. (2018) Introduction to the Cancer Intervention and Surveillance Modeling Network (CISNET) Breast Cancer Models. Med Decis Making 38:3S-8S
Gallaher, Jill; Babu, Aravind; Plevritis, Sylvia et al. (2014) Bridging population and tissue scale tumor dynamics: a new paradigm for understanding differences in tumor growth and metastatic disease. Cancer Res 74:426-435
Schackmann, Elizabeth A; Munoz, Diego F; Mills, Meredith A et al. (2013) Feasibility evaluation of an online tool to guide decisions for BRCA1/2 mutation carriers. Fam Cancer 12:65-73
Lin, Ray S; Plevritis, Sylvia K (2012) Comparing the benefits of screening for breast cancer and lung cancer using a novel natural history model. Cancer Causes Control 23:175-85
Sigal, Bronislava M; Munoz, Diego F; Kurian, Allison W et al. (2012) A simulation model to predict the impact of prophylactic surgery and screening on the life expectancy of BRCA1 and BRCA2 mutation carriers. Cancer Epidemiol Biomarkers Prev 21:1066-77
Kurian, Allison W; Munoz, Diego F; Rust, Peter et al. (2012) Online tool to guide decisions for BRCA1/2 mutation carriers. J Clin Oncol 30:497-506
Bailey, Stephanie L; Sigal, Bronislava M; Plevritis, Sylvia K (2010) A simulation model investigating the impact of tumor volume doubling time and mammographic tumor detectability on screening outcomes in women aged 40-49 years. J Natl Cancer Inst 102:1263-71
Kurian, Allison W; Sigal, Bronislava M; Plevritis, Sylvia K (2010) Survival analysis of cancer risk reduction strategies for BRCA1/2 mutation carriers. J Clin Oncol 28:222-31
Mandelblatt, Jeanne S; Cronin, Kathleen A; Bailey, Stephanie et al. (2009) Effects of mammography screening under different screening schedules: model estimates of potential benefits and harms. Ann Intern Med 151:738-47
Plevritis, Sylvia K; Kurian, Allison W; Sigal, Bronislava M et al. (2006) Cost-effectiveness of screening BRCA1/2 mutation carriers with breast magnetic resonance imaging. JAMA 295:2374-84

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