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Activity Number:
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328
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Type:
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Topic Contributed
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Date/Time:
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Wednesday, August 11, 2004 : 10:30 AM to 12:20 PM
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Sponsor:
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Section on Health Policy Statistics
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| Abstract - #300503 |
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Title:
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Using Monte Carlo Simulation to Estimate the Effect of Aspirin Use on Progression of Colorectal Cancer
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Author(s):
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Karen M. Kuntz*+ and Jane C. Weeks and Milton C. Weinstein and Graham A. Colditz
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Companies:
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Harvard School of Public Health and Dana-Farber Cancer Institute and Harvard School of Public Health and Brigham and Women's Hospital
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Address:
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, , ,
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Keywords:
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colorectal cancer ; simulation model
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Abstract:
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We used a novel combination of epidemiological analysis and Monte Carlo simulation to infer the effects of aspirin use on unobservable states of colorectal disease. Using a state-transition model of colorectal disease in which aspirin use "slows" disease progression, we simulated a variety of potential aspirin effects and compared their influence on diagnosed colorectal cancer (CRC) with the association between duration of aspirin use and diagnosed CRC observed in a large prospective study. We modified the aspirin effects and repeated the simulations until the simulated relationship between duration of aspirin use and diagnosed cancer was consistent with the observed relationship. The simulation results suggest that aspirin is unlikely to reduce CRC risk solely by decreasing adenoma incidence or solely by slowing adenoma progression to malignancy. Instead, it appears that aspirin acts at multiple points in the disease by exerting a strong influence on adenoma emergence and a relatively weaker influence on adenoma progression. Simulation modeling can play an important role in improving our understanding of disease and informing clinical and preventive guidelines.
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