Modeling to guide cancer control research and priorities

The CISNET consortium is an international consortium of cancer modelers studying the roles of prevention, screening, and treatment in explaining population cancer trends. There are multiple cancer sites funded in this consortium and the MGH ITA has investigators contributing to Cervical, Colorectal, Esophageal, and Lung cancer groups. The MGH ITA houses the coordinating center for the Esophageal cancer working group, with Principal Investigator Chin Hur. Amy Knudsen, is a Co-Investigator with the CISNET colorectal research group and Joey Kong is a Co-Principal Investigator for the lung research group.

Sophisticated modeling techniques can be powerful tools for decision makers seeking to understand the effects of cancer control interventions on population trends in cancer incidence and mortality. Yet the proven value of such models in health policy is limited by legitimate concerns over lack of transparency of complex models and variability in published results from different groups. CISNET was created to promote collaboration between independent modeling groups investigating similar questions. By using the same sources of data for inputs and agreeing on uniform outcome measures, the variability in results reflects uncertainty in the effects of cancer control interventions rather than differences in design of the analysis. Further, by working together, the modeling groups can coherently explain the causes of variation.

Research conducted through the CISNET working groups have translated evidence from randomized trials and epidemiological studies to the population setting by extrapolating evidence to the general population, modeled real and hypothetical scenarios to identify key factors including outcomes and cancer control strategies, and informed clinical practice and guidelines by synthesizing existing information to model gaps in available knowledge.

CISNET models have particularly been used to inform decisions by the US Preventive Services Task Force, which makes evidence-based recommendations about clinical preventive services for the US. CISNET models have collaborated with Evidence-Based Practice Centers (EPC) – who are charged to gather and summarize available evidence on a specific topic. CISNET models work with the USPSTF and investigators at the EPC to model specific questions based on available evidence gathered from scientific peer-reviewed literature and gaps in this knowledge base in order to provide information to the USPSTF to inform their decisions.

CISNET models at the ITA were utilized to inform USPSTF decisions in Lung Cancer Screening in 2013, Colorectal Cancer in 2008, and Colorectal Cancer that is currently being updated.

 

This activity is supported by grants from the National Institutes of Health/National Cancer Institute (U01CA199335 – Colorectal, U01CA199334 – Cervical, U01CA199336 – Esophageal, U01CA199284 – Lung)