Comparing CISNET Breast Cancer Incidence and Mortality Predictions to Observed Clinical Trial Results of Mammography Screening from Ages 40 to 49

Jeroen J. van den Broek; Nicolien T. van Ravesteyn; Jeanne S. Mandelblatt; Hui Huang; Mehmet Ali Ergun; Elizabeth S. Burnside; Cong Xu; Yisheng Li; Oguzhan Alagoz; Sandra J. Lee; Natasha K. Stout; Juhee Song; Amy Trentham-Dietz; Sylvia K. Plevritis; Sue M. Moss; Harry J. de Koning

doi:10.1177/0272989X17718168

Comparing CISNET Breast Cancer Incidence and Mortality Predictions to Observed Clinical Trial Results of Mammography Screening from Ages 40 to 49

Jeroen J. van den Broek^*, Nicolien T. van Ravesteyn, Jeanne S. Mandelblatt, Hui Huang, Mehmet Ali Ergun, Elizabeth S. Burnside, Cong Xu, Yisheng Li, Oguzhan Alagoz, Sandra J. Lee, Natasha K. Stout, Juhee Song, Amy Trentham-Dietz, Sylvia K. Plevritis, Sue M. Moss, Harry J. de Koning

^*Corresponding author for this work

Managerial Economics, Decision Sciences and Operations

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12 Scopus citations

Abstract

Background. The UK Age trial compared annual mammography screening of women ages 40 to 49 years with no screening and found a statistically significant breast cancer mortality reduction at the 10-year follow-up but not at the 17-year follow-up. The objective of this study was to compare the observed Age trial results with the Cancer Intervention and Surveillance Modeling Network (CISNET) breast cancer model predicted results. Methods. Five established CISNET breast cancer models used data on population demographics, screening attendance, and mammography performance from the Age trial together with extant natural history parameters to project breast cancer incidence and mortality in the control and intervention arm of the trial. Results. The models closely reproduced the effect of annual screening from ages 40 to 49 years on breast cancer incidence. Restricted to breast cancer deaths originating from cancers diagnosed during the intervention phase, the models estimated an average 15% (range across models, 13% to 17%) breast cancer mortality reduction at the 10-year follow-up compared with 25% (95% CI, 3% to 42%) observed in the trial. At the 17-year follow-up, the models predicted 13% (range, 10% to 17%) reduction in breast cancer mortality compared with the non-significant 12% (95% CI, -4% to 26%) in the trial. Conclusions. The models underestimated the effect of screening on breast cancer mortality at the 10-year follow-up. Overall, the models captured the observed long-term effect of screening from age 40 to 49 years on breast cancer incidence and mortality in the UK Age trial, suggesting that the model structures, input parameters, and assumptions about breast cancer natural history are reasonable for estimating the impact of screening on mortality in this age group.

Original language	English (US)
Pages (from-to)	140S-150S
Journal	Medical Decision Making
Volume	38
Issue number	1_suppl
DOIs	https://doi.org/10.1177/0272989X17718168
State	Published - Apr 1 2018

Funding

Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands (JJV, NTV, HJD); Department of Oncology, Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University School of Medicine, Washington DC, USA (JSM); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA (ESB); Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA (MAE, OA, AT); Department of Radiology, School of Medicine, Stanford University, Stanford, CA, USA (CX, SKP); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, Boston, MA, USA (HH, SJL); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA (NKS); Department of Biostatistics, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA (YL, JS); Department of cancer prevention, Wolfson Institute, Queen Mary University of London, London, UK (SMM). This work was supported by the National Institutes of Health under National Cancer Institute Grants U01CA152958 and U01CA199218.

Keywords

CISNET
breast cancer models
external validation
mammography trial simulation

ASJC Scopus subject areas

Health Policy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/0272989X17718168

Cite this

van den Broek, J. J., van Ravesteyn, N. T., Mandelblatt, J. S., Huang, H., Ergun, M. A., Burnside, E. S., Xu, C., Li, Y., Alagoz, O., Lee, S. J., Stout, N. K., Song, J., Trentham-Dietz, A., Plevritis, S. K., Moss, S. M., & de Koning, H. J. (2018). Comparing CISNET Breast Cancer Incidence and Mortality Predictions to Observed Clinical Trial Results of Mammography Screening from Ages 40 to 49. Medical Decision Making, 38(1_suppl), 140S-150S. https://doi.org/10.1177/0272989X17718168

@article{29b5365755dd4a39b9e10cdd0a2b3a6a,

title = "Comparing CISNET Breast Cancer Incidence and Mortality Predictions to Observed Clinical Trial Results of Mammography Screening from Ages 40 to 49",

abstract = "Background. The UK Age trial compared annual mammography screening of women ages 40 to 49 years with no screening and found a statistically significant breast cancer mortality reduction at the 10-year follow-up but not at the 17-year follow-up. The objective of this study was to compare the observed Age trial results with the Cancer Intervention and Surveillance Modeling Network (CISNET) breast cancer model predicted results. Methods. Five established CISNET breast cancer models used data on population demographics, screening attendance, and mammography performance from the Age trial together with extant natural history parameters to project breast cancer incidence and mortality in the control and intervention arm of the trial. Results. The models closely reproduced the effect of annual screening from ages 40 to 49 years on breast cancer incidence. Restricted to breast cancer deaths originating from cancers diagnosed during the intervention phase, the models estimated an average 15% (range across models, 13% to 17%) breast cancer mortality reduction at the 10-year follow-up compared with 25% (95% CI, 3% to 42%) observed in the trial. At the 17-year follow-up, the models predicted 13% (range, 10% to 17%) reduction in breast cancer mortality compared with the non-significant 12% (95% CI, -4% to 26%) in the trial. Conclusions. The models underestimated the effect of screening on breast cancer mortality at the 10-year follow-up. Overall, the models captured the observed long-term effect of screening from age 40 to 49 years on breast cancer incidence and mortality in the UK Age trial, suggesting that the model structures, input parameters, and assumptions about breast cancer natural history are reasonable for estimating the impact of screening on mortality in this age group.",

keywords = "CISNET, breast cancer models, external validation, mammography trial simulation",

author = "{van den Broek}, {Jeroen J.} and {van Ravesteyn}, {Nicolien T.} and Mandelblatt, {Jeanne S.} and Hui Huang and Ergun, {Mehmet Ali} and Burnside, {Elizabeth S.} and Cong Xu and Yisheng Li and Oguzhan Alagoz and Lee, {Sandra J.} and Stout, {Natasha K.} and Juhee Song and Amy Trentham-Dietz and Plevritis, {Sylvia K.} and Moss, {Sue M.} and {de Koning}, {Harry J.}",

note = "Publisher Copyright: {\textcopyright} 2017, {\textcopyright} The Author(s) 2017.",

year = "2018",

month = apr,

day = "1",

doi = "10.1177/0272989X17718168",

language = "English (US)",

volume = "38",

pages = "140S--150S",

journal = "Medical Decision Making",

issn = "0272-989X",

publisher = "SAGE Publications Inc.",

number = "1_suppl",

}

van den Broek, JJ, van Ravesteyn, NT, Mandelblatt, JS, Huang, H, Ergun, MA, Burnside, ES, Xu, C, Li, Y, Alagoz, O, Lee, SJ, Stout, NK, Song, J, Trentham-Dietz, A, Plevritis, SK, Moss, SM & de Koning, HJ 2018, 'Comparing CISNET Breast Cancer Incidence and Mortality Predictions to Observed Clinical Trial Results of Mammography Screening from Ages 40 to 49', Medical Decision Making, vol. 38, no. 1_suppl, pp. 140S-150S. https://doi.org/10.1177/0272989X17718168

Comparing CISNET Breast Cancer Incidence and Mortality Predictions to Observed Clinical Trial Results of Mammography Screening from Ages 40 to 49. / van den Broek, Jeroen J.; van Ravesteyn, Nicolien T.; Mandelblatt, Jeanne S. et al.
In: Medical Decision Making, Vol. 38, No. 1_suppl, 01.04.2018, p. 140S-150S.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Comparing CISNET Breast Cancer Incidence and Mortality Predictions to Observed Clinical Trial Results of Mammography Screening from Ages 40 to 49

AU - van den Broek, Jeroen J.

AU - van Ravesteyn, Nicolien T.

AU - Mandelblatt, Jeanne S.

AU - Huang, Hui

AU - Ergun, Mehmet Ali

AU - Burnside, Elizabeth S.

AU - Xu, Cong

AU - Li, Yisheng

AU - Alagoz, Oguzhan

AU - Lee, Sandra J.

AU - Stout, Natasha K.

AU - Song, Juhee

AU - Trentham-Dietz, Amy

AU - Plevritis, Sylvia K.

AU - Moss, Sue M.

AU - de Koning, Harry J.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Background. The UK Age trial compared annual mammography screening of women ages 40 to 49 years with no screening and found a statistically significant breast cancer mortality reduction at the 10-year follow-up but not at the 17-year follow-up. The objective of this study was to compare the observed Age trial results with the Cancer Intervention and Surveillance Modeling Network (CISNET) breast cancer model predicted results. Methods. Five established CISNET breast cancer models used data on population demographics, screening attendance, and mammography performance from the Age trial together with extant natural history parameters to project breast cancer incidence and mortality in the control and intervention arm of the trial. Results. The models closely reproduced the effect of annual screening from ages 40 to 49 years on breast cancer incidence. Restricted to breast cancer deaths originating from cancers diagnosed during the intervention phase, the models estimated an average 15% (range across models, 13% to 17%) breast cancer mortality reduction at the 10-year follow-up compared with 25% (95% CI, 3% to 42%) observed in the trial. At the 17-year follow-up, the models predicted 13% (range, 10% to 17%) reduction in breast cancer mortality compared with the non-significant 12% (95% CI, -4% to 26%) in the trial. Conclusions. The models underestimated the effect of screening on breast cancer mortality at the 10-year follow-up. Overall, the models captured the observed long-term effect of screening from age 40 to 49 years on breast cancer incidence and mortality in the UK Age trial, suggesting that the model structures, input parameters, and assumptions about breast cancer natural history are reasonable for estimating the impact of screening on mortality in this age group.

AB - Background. The UK Age trial compared annual mammography screening of women ages 40 to 49 years with no screening and found a statistically significant breast cancer mortality reduction at the 10-year follow-up but not at the 17-year follow-up. The objective of this study was to compare the observed Age trial results with the Cancer Intervention and Surveillance Modeling Network (CISNET) breast cancer model predicted results. Methods. Five established CISNET breast cancer models used data on population demographics, screening attendance, and mammography performance from the Age trial together with extant natural history parameters to project breast cancer incidence and mortality in the control and intervention arm of the trial. Results. The models closely reproduced the effect of annual screening from ages 40 to 49 years on breast cancer incidence. Restricted to breast cancer deaths originating from cancers diagnosed during the intervention phase, the models estimated an average 15% (range across models, 13% to 17%) breast cancer mortality reduction at the 10-year follow-up compared with 25% (95% CI, 3% to 42%) observed in the trial. At the 17-year follow-up, the models predicted 13% (range, 10% to 17%) reduction in breast cancer mortality compared with the non-significant 12% (95% CI, -4% to 26%) in the trial. Conclusions. The models underestimated the effect of screening on breast cancer mortality at the 10-year follow-up. Overall, the models captured the observed long-term effect of screening from age 40 to 49 years on breast cancer incidence and mortality in the UK Age trial, suggesting that the model structures, input parameters, and assumptions about breast cancer natural history are reasonable for estimating the impact of screening on mortality in this age group.

KW - CISNET

KW - breast cancer models

KW - external validation

KW - mammography trial simulation

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U2 - 10.1177/0272989X17718168

DO - 10.1177/0272989X17718168

M3 - Article

C2 - 29554468

AN - SCOPUS:85044253397

SN - 0272-989X

VL - 38

SP - 140S-150S

JO - Medical Decision Making

JF - Medical Decision Making

IS - 1_suppl

ER -

Comparing CISNET Breast Cancer Incidence and Mortality Predictions to Observed Clinical Trial Results of Mammography Screening from Ages 40 to 49

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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