title: Heterogeneity in multistage carcinogenesis and mixture modeling.
abstract: Carcinogenesis is commonly described as a multistage process, in which stem cells are transformed into cancer cells via a series of mutations. In this article, we consider extensions of the multistage carcinogenesis model by mixture modeling. This approach allows us to describe population heterogeneity in a biologically meaningful way. We focus on finite mixture models, for which we prove identifiability. These models are applied to human lung cancer data from several birth cohorts. Maximum likelihood estimation does not perform well in this application due to the heavy censoring in our data. We thus use analytic graduation instead. Very good fits are achieved for models that combine a small high risk group with a large group that is quasi immune.
authors.affiliation: Institute of Mathematics, Swiss Federal Institute of Technology, Lausanne, Switzerland. sandro.gsteiger@a3.epfl.ch
authors.forename: Sandro
authors.initials: S
authors.lastname: Gsteiger
authors.forename: Stephan
authors.initials: S
authors.lastname: Morgenthaler
mesh_terms: D000465:Algorithms; D002454:Cell Differentiation; D002471:Cell Transformation, Neoplastic; D015331:Cohort Studies; D004252:DNA Mutational Analysis; D044127:Epigenesis, Genetic; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D008954:Models, Biological; D015233:Models, Statistical; D016016:Proportional Hazards Models; D013997:Time Factors