Diversity of model approaches for breast cancer screening: a review of model assumptions by the Cancer Intervention and Surveillance Network (CISNET) Breast Cancer Groups

Boer, Rob; Plevritis, Sylvia; Clarke, Lauren
December 2004
Statistical Methods in Medical Research;Dec2004, Vol. 13 Issue 6, p525
Academic Journal
journal article
The National Cancer Institute-sponsored Cancer Intervention and Surveillance Network program on breast cancer is composed of seven research groups working largely independently to model the impact of screening and adjuvant therapy on breast cancer mortality trends in the US from 1975 to 2000. Each of the groups has chosen a different modeling methodology without purposeful attempt to be in contrast with each other. The seven groups have met biannually since November 2000 to discuss their methodology and results. This article investigates the differences in methodology. To facilitate this comparison, each of the groups submitted a description of their model into a uniformly structured web based 'model profiler'. Six of the seven models simulate a preclinical natural history that cannot be observed directly with parameters estimated from published evidence concerning screening and therapy effects. The remaining model regards published evidence on intervention effects as prior information and updates that with information from the US population in a Bayesian type analysis. In general, the differences between the models appear to be small, particularly among the models driven by natural history assumptions. However, we demonstrate that such apparently small differences can have a large impact on surveillance of population trends. We describe a systematic approach to evaluating differences in model assumptions and results, as well as differences in modeling culture underlying the differences in model structure and parameters.


Related Articles

  • Cancer mortality in the 50-69 year age group before and after screening. W. Duffy, S.; Tabar, L.; Olsen, A. H.; Vitak, B.; Allgood, P. C.; Chen, T. H.; Yen, A. M.; Smith, R. A. // Journal of Medical Screening;Sep2010, Vol. 17 Issue 3, p159 

    A response by S. W. Duffy and colleagues on their article "Absolute numbers of lives saved and overdiagnosis in breast cancer screening, from a randomised trial and from the breast screening programme in England" in the previous issue is presented.

  • Explaining the difference in prognosis between screen-detected and symptomatic breast cancers. Allgood, P. C.; Duffy, S. W.; Kearins, O.; O'Sullivan, E.; Tappenden, N.; Wallis, M. G.; Lawrence, G. // British Journal of Cancer;5/24/2011, Vol. 104 Issue 11, p1680 

    Background: We analysed 10-year survival data in 19,411 women aged 50-64 years diagnosed with invasive breast cancer in the West Midlands region of the United Kingdom. The aim was to estimate the survival advantage seen in cases that were screen detected compared with those...

  • NIH Statement on Adjuvant Therapy for Breast Cancer. Hellekson, Karen L. // American Family Physician;5/1/2001, Vol. 63 Issue 9, p1857 

    Presents the statement released by the United States National Institutes of Health on the use of adjuvant therapy for breast cancer. Factors to be considered in the selection of a systemic adjuvant therapy; Recommendations for the use of other therapies such as hormone therapy, chemotherapy and...

  • Why we need more breast cancer screening trials. Fenton, Joshua J.; Miglioretti, Diana L. // Evidence Based Medicine;Dec2012, Vol. 17 Issue 6, p169 

    The authors reflect on the need to have more breast cancer screening studies with the mammography test having a high false-positive rate and failing to detect one in five breast cancers. They state that clinical trials are necessary to make more informed clinical and policy decisions. They also...

  • Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data. Vilaprinyo, Ester; Rué, Montserrat; Marcos-Gragera, Rafael; Martínez-Alonso, Montserrat // BMC Cancer;2009, Vol. 9, Special section p1 

    Background: During the last part of the 1990s the chance of surviving breast cancer increased. Changes in survival functions reflect a mixture of effects. Both, the introduction of adjuvant treatments and early screening with mammography played a role in the decline in mortality. Evaluating the...

  • Breast cancer screening rates drop.  // Australian Nursing & Midwifery Journal;Aug2015, Vol. 23 Issue 2, p5 

    The article reports on the decline of participation rates of Australian women who screens for breast cancer according to the report from Australian Institute of Health and Welfare.

  • Barnsley Breast Screening Goes Digital.  // Operating Theatre Journal;Jun2012, Issue 261, p12 

    The article reports that Barnsley Hospital's Breast Screening Unit was re-opened on 13 February, 2012 after it was refurbished and converted to a digital imaging unit with the installation of two new Fujifilm Amulet 24x30 digital machines.

  • Variations in screening outcome among pairs of screening radiologists at non-blinded double reading of screening mammograms: a population-based study. Klompenhouwer, E.; Duijm, L.; Voogd, A.; Heeten, G.; Nederend, J.; Jansen, F.; Broeders, M. // European Radiology;May2014, Vol. 24 Issue 5, p1097 

    Objectives: Substantial inter-observer variability in screening mammography interpretation has been reported at single reading. However, screening results of pairs of screening radiologists have not yet been published. We determined variations in screening performances among pairs of screening...

  • Small steps, big breakthroughs. Singer, Karl // Patient Care;7/30/2000, Vol. 34 Issue 14, p6 

    Editorial. Discusses factors contributing to the decline in breast cancer mortality in the United States. Recommendations in 1985 by the U.S. National Institute of Health (NIH) Consensus Development Conference panel on Adjuvant Chemotherapy of Breast Cancer; Usefulness of chemotherapy and...

  • Hand evaluation to NICE. Juhl Jrgensen, Karsten; Gtzsche, Peter C. // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;11/26/2011, Vol. 343 Issue 7833, p1094 

    A letter to the editor is presented in response to the article "An independent review is underway," by M. Richards in the October 25, 2011 issue.


Read the Article

Courtesy of

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics