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Principal Investigator: Marvin Zelen
Institution: Dana-Farber Cancer Institute
Grant Number: 2U01CA088270-05
Awarded under CA-05-018
Originally funded under CA-99-013 (view abstract)
Abstract: The major goals of this proposal are to apply the stochastic
model developed earlier to breast cancer issues associated with the US population. Among
the issues which will be studied are: estimating the US breast cancer mortality for the period
2005-2020; investigate mortality for sub-populations (e.g., African-American, uninsured population
and various scenarios); continue investigations of optimal screening schedules; investigate
the role of the underreporting in SEER of invasive breast cancer following ductal carcinoma
in situ (DCIS); investigate the influence on mortality if the number of women taking tamoxifen
or reloxifene as a preventive agent is increased; develop a public web site (a) which will
allow investigators to make use of our theoretical breast cancer model and (b) to communicate
to the general public the breast cancer predicted mortality and false positive rate for any
screening program.
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Awarded under CA-99-013
Abstract:
The major goals of this proposal are to develop and extend statistical models which are important
in predicting the future incidence and mortality associated with breast cancer in the United
States. The diagnosis, treatment and prevention of female breast cancer has been rapidly
changing in the decade and shows every evidence of continuing to change. Our main thrust
will be to estimate the impact of interventions on national statistics. The interventions
will not only reflect current health behavior practice, but will reflect various scenarios
if public health practices were to change. Among the problems which will be considered are:
(1) to evaluate the relation between early detection and eventual mortality which considers
competing risks; (2) to predict the changing incidence patterns if more women participate
in routine screening programs; (3) to compare the trade-offs pertaining to both benefit and
cost between optimal screening programs and recommended policies; (4) to develop optimal
screening programs for high risk sub-populations; (5) to estimate the change in mortality
if modern cancer treatment was routinely given to a higher proportion of the population;
(6) to use the Eastern Cooperative Oncology Group (ECOG) and the Harvard Pilgrim Health Plan
as a resource to gather data on diagnosis and staging currently not available; (7) to investigate
screening policies and their benefit for younger women; (8) to estimate the impact of improved
methods of diagnosis on incidence and mortality.
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