title: The MISCAN-Fadia continuous tumor growth model for breast cancer.
abstract: The MISCAN-Fadia model was used to analyze the impact of screening and adjuvant treatment on U.S. breast cancer mortality between 1975 and 2000. MISCAN-Fadia uses the concept of "fatal diameter" to model survival and screening benefit and is based on continuous tumor growth. It consists of four major components: population, natural history, screening, and treatment. Population parameters were quantified using U.S. population data. Most natural history and screening parameters were fitted to the Swedish Two County screening trial data; some were based on Surveillance, Epidemiology, and End Results data. Adjuvant treatment parameters were quantified using data from the Early Breast Cancer Trialists' Collaborative Group's meta-analysis. The simulated trend in incidence matches the observed trend reasonably well; the simulated mortality is equal to the observed in 1975 but becomes increasingly too high in 2000. We estimate that screening leads to a 15% and adjuvant treatment to a 21% mortality reduction in the year 2000.
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Sita Y G L
authors.initials: SY
authors.lastname: Tan
authors.forename: Gerrit J
authors.initials: GJ
authors.lastname: van Oortmarssen
authors.forename: Harry J
authors.initials: HJ
authors.lastname: de Koning
authors.forename: Rob
authors.initials: R
authors.lastname: Boer
authors.forename: J Dik F
authors.initials: JD
authors.lastname: Habbema
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data; D015201:Meta-Analysis as Topic; D015233:Models, Statistical; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology; D014481:United States / Q000453:epidemiology