this is the answer Caswell-King et al. (2024) Aim to answer. The authors used 4 cancer mortality models within CISNET in this study:
- Type D (Dana Farber Cancer Institute). used to define a set of disease states and implement analytical formulas to estimate the association between interventions and transitions between these states and breast cancer incidence and mortality.
- Type M (MD Anderson Cancer Center).Relies on Bayesian methods that evaluate probability distributions of unknown parameters, including treatment effects, and fit to observed breast cancer mortality
- Type S (Stanford University). Microsimulation that models the natural history of disease based on tumor size and stage progression mapped to detection; treatment effect applied to baseline survival curves based on stage, age, and estrogen receptor (ER)/ERBB2 (before HER2) status during detection.
- Type W (University of Wisconsin-Harvard). The model uses a tumor growth framework and is calibrated for morbidity and mortality based on the Surveillance, Epidemiology, and End Results Program (SEER) registry. The model also contains a solidification fraction.
Breast cancer categories by ER/ERBB2 Status (ER+/ERBB2−, ER+/ERBB2+, yes–/ERBB2+, and emergency room–/ERBB2−) are modeled separately.
Using this approach, the authors found:
The breast cancer mortality rate (age-adjusted) in the United States was 48/100,000 women in 1975 and 27/100,000 women in 2019. In 2019, the combination of screening, stage I to stage III treatment, and metastatic treatment was associated with a 58% reduction in breast cancer mortality (model range, 55%-61%). Of these, 29% (model range, 19%-33%) were associated with treatment of metastatic breast cancer, 47% (model range, 35%-60%) were associated with treatment of stage I to III breast cancer, and 25% (model range, 21%-33%) versus mammography screening. According to the simulations, the largest change in survival after metastatic recurrence occurred between 2000 and 2019, from 1.9 years (model range, 1.0-2.7 years) to 3.2 years (model range, 2.0-4.9 years).
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