.. _2017_cancer_model_breast_cancer: ============= Breast Cancer ============= Disease Overview ---------------- .. todo:: Add definition of each cancer. In particular, find data about global prevalence and disease fatal and non fatal description. GBD 2017 Modeling Strategy -------------------------- Breast cancer in GBD 2017 ++++++++++++++++++++++++++ The GBD modelling strategy can be found in the GBD YLD Capstone Appendix [GBD-2017-YLD-Capstone-Appendix-1-Breast-Cancer]_. Incidence is estimated directly from mortality using mortality to incidence ratios (MIR). Because of long-term disability associated with mastectomy, prevalence for breast cancer is estimated beyond ten years. To estimate the disability, total prevalence for breast cancer is split into #. Diagnosis and primary therapy #. Controlled phase #. Controlled phase of breast cancer, with mastectomy #. Controlled phase of breast cancer, without mastectomy #. Metastatic phase #. Terminal phase #. Mastectomy from breast cancer, beyond 10 years .. todo:: Add more details about GBD modelling strategy of Breast cancer. Cause Hierarchy ++++++++++++++++ +-------------------------------------------------------------------------------------------------------------+ | GBD breast cancer cause hierarchy | +===============+======================+=======+=================================+============================+ | Cause name | GBD cause id | Level | Sequaelae | | +---------------+----------------------+-------+---------------------------------+----------------------------+ | All causes | c_294 | 0 | | | +---------------+----------------------+-------+---------------------------------+----------------------------+ | All NCDs | c_409 | 1 | | | +---------------+----------------------+-------+---------------------------------+----------------------------+ | Neoplasms | C_410 | 2 | | | +---------------+----------------------+-------+---------------------------------+----------------------------+ | Breast cancer | C_429 | 3 | diagnosis_and_primary_therapy_phase_of_breast_cancer (s_277) | | | | | metastatic_phase_of_breast_cancer (s_279) | | | | | terminal_phase_of_breast_cancer (s_280) | | | | | controlled_phase_of_breast_cancer_with_mastectomy (s_5486) | | | | | controlled_phase_of_breast_cancer_without_mastectomy (s_5489)| | | | | mastectomy_from_breast_cancer_beyond_ten_years (s_5492) | +---------------+----------------------+-------+--------------------------------------------------------------+ .. image:: breast_cancer_hierarchy.svg Restrictions ++++++++++++ The following table describes any restrictions on the effects of this cause (such as being only fatal or only nonfatal), as well as restrictions on the age and sex of simulants to which different aspects of the cause model apply. .. list-table:: Restrictions :widths: 15 15 20 :header-rows: 1 * - Restriction Type - Value - Notes * - Male only - False - * - Female only - False - * - YLL only - False - * - YLD only - False - * - YLL age group start - 15 to 19 - GBD age group id 8 * - YLL age group end - 95 plus - GBD age group id 235 * - YLD age group start - 15 to 19 - GBD age group id 8 * - YLD age group end - 95 plus - GBD age group id 235 Vivarium Modeling Strategy -------------------------- Scope +++++ .. todo:: Add scope. Model Assumptions and Limitations +++++++++++++++++++++++++++++++++ 1. Within GBD 2017, after diagnosis/ treatment if a patient survives more than 10 years, they are considered cured for calculating disability. For simulation models, this means that if the simulation is run for more than 10 years, then excess mortality rate exists due to cancer after 10 years and the number of deaths increase. But as per GBD 2017, after 10 years, the patients do not have excess mortality rate. So, this model might over estimate deaths in that scenario. .. todo:: Add more assumptions and limitations. Cause Model Diagram +++++++++++++++++++ Within GBD 2017 data, the remission rate is not available which makes it difficult to transition through the states. So, due to data limitations we are simplifying the model. Note: This simpliflication might over estimate the number of deaths. See Model Assumptions and Limitations section for more information. .. image:: cancer_cause_model.svg State and Transition Data Tables ++++++++++++++++++++++++++++++++ .. list-table:: Definitions :widths: 15 20 30 :header-rows: 1 * - State - State Name - Definition * - S - Susceptible - Susceptible to breast cancer * - I - Infected - Infected with breast cancer .. list-table:: States Data :widths: 20 25 30 30 :header-rows: 1 * - State - Measure - Value - Notes * - S - prevalence - 1-prevalence_c429 - * - S - excess mortality rate - 0 - * - S - disabilty weights - 0 - * - I - prevalence - prevalence_c429 - * - I - excess mortality rate - :math:`\frac{\text{deaths\_c429}}{\text{population} \times \text{prevalence\_c429}}` - * - I - disability weights - :math:`\displaystyle{\sum_{s\in \text{sequelae\_c429}}} \scriptstyle{\text{disability\_weight}_s \,\times\, \text{prevalence}_s}` - total disability weight over all sequelae with ids s_277, s_5486, s_5489, s_279, s_280, s_5492 * - ALL - cause specific mortality rate - :math:`\frac{\text{deaths\_c429}}{\text{population}}` - .. list-table:: Transition Data :widths: 10 10 10 30 30 :header-rows: 1 * - Transition - Source - Sink - Value - Notes * - i - S - I - :math:`\frac{\text{incidence\_rate\_c429}}{\text{1 - prevalence\_c429}}` - Incidence rate in total population is divided by 1-prevalence_c429 to get incidence rate among the susceptible population. .. list-table:: Data Sources :widths: 20 25 25 25 :header-rows: 1 * - Measure - Sources - Description - Notes * - prevalence_c429 - como - Prevalence of cause breast cancer - * - deaths_c429 - codcorrect - Deaths from breast cancer - * - population - demography - Mid-year population for given country - * - incidence_rate_c429 - como - Incidence rate for breast cancer - * - disability_weight_s{`sid`} - YLD appendix - Disability weights associated with each sequelae - * - prevalence_s{`sid`} - como - Prevalence of each sequelae - Validation Criteria +++++++++++++++++++ .. todo:: Describe tests for model validation. References ---------- .. [GBD-2017-YLD-Capstone-Appendix-1-Breast-Cancer] Supplement to: `GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1789–858` (pp. 310-317)