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MedicineMedicine and Medical Research

Individualized Strategies for Breast Cancer Surveillance Based on Aggregated Familial Information

Authors: Andrei Y. Yakovlev; UTAH UNIV SALT LAKE CITY
Abstract:
This work is concerned with methodological aspects of a new approach to optimization of breast cancer screening designed to utilize aggregated family history information. The problem of optimal cancer surveillance is set up as a search for optimal scheduling of screening examinations subject to certain constraints on the number and timing of medical tests. In Year 1, we developed a mathematical model yielding an algorithm for designing optimal schedules of breast cancer screening. An explicit expression of the efficiency functional is based on a plausible assumption that the intensity of detection (the hazard function for the age at detection) is proportional to the current tumor size. The main advantage of the proposed approach is that it accommodates cohort data of a fairly general structure, not only the data resulting from screening trials. We have also developed several numerical algorithms and software for estimating the hazard function for breast cancer incidence from the data amassed in the Utah Population Data Base; these procedures will be used (in Year 2) for testing covariate effects associated with different indicators of family history.

Limitations: APPROVED FOR PUBLIC RELEASE
Description: Annual rept. 1 Jan 99-31 Dec 99
Pages: 39
Report Date: JAN 2000
Contract Number: DAMD17-98-1-8256
Report Number: A798583
Keywords relating to this report:
*BREAST CANCER
ALGORITHMS
CANCER SCREENING
COMPUTER PROGRAMS
COVARIANCE
DATA BASES
DETECTION
EFFICIENCY
FAMILIES_HUMAN_
FUNCTIONS
HAZARDS
HISTORY
INDICATORS
INTENSITY
MATHEMATICAL MODELS
MEDICINE
NEOPLASMS
OPTIMIZATION
POPULATION
SCHEDULING
SIZES_DIMENSIONS_
SURVEILLANCE
TEST AND EVALUATION
UTAH
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