Cancers

This is a common document for the cancers that are modelled similarly in GBD. This document currently has information related to the following cancers:

• Tracheal, bronchus and lung cancer

• Cervical cancer

• Stomach Cancer

• Kidney cancer

• Gallbladder and biliary tract cancer

• Esophageal cancer

• Pancreatic cancer

• Thyroid cancer

• Non-hodgkin lymphoma

• Multiple myeloma

• Other pharynx cancer

• Nasopharynx cancer

• Lip and oral cavity cancer

• Ovarian cancer

• Uterine cancer

Any of the other cancers that have similar modelling strategy can be added to this list.

Disease Overview

Todo

Add individual definitions of each cancer. In particular, find data about global prevalence and disease fatal and non fatal description.

GBD 2017 Modeling Strategy

Cancers in GBD 2017

GBD 2017 uses similar modeling strategies to estimate the prevalence and resulting disability of these categories of cancers [GBD-2017-YLD-Capstone-Appendix-1-Neoplasms].

Incidence is estimated directly from mortality using mortality to incidence ratios (MIR).

Prevalence for all these cancers are estimated for a maximum of ten years. To estimate the disability, total prevalence for each cancer is split into

1. Diagnosis and primary therapy

2. Controlled phase

3. Metastatic phase

4. Terminal phase

Todo

Add more details about cancer modeling in GBD 2017.

Cause Hierarchy

The following table helps to identify cause id and associated sequelae ids for each cancer.

Ids of causes and associated sequelae

Cancer	Cause Id	Sequelae Ids
Esophageal cancer	c_411	s_244, s_245, s_246, s_247
Stomach cancer	c_414	s_248, s_249, s_250, s_251
Tracheal, bronchus and lung cancer	c_426	s_273, s_274, s_275, s_280
Cervical cancer	c_432	s_282, s_283, s_284, s_285
Uterine cancer	c_435	s_286, s_287, s_288, s_289
Lip and oral cavity cancer	c_444	s_301, s_302, s_303, s_304
Nasopharynx cancer	c_447	s_305, s_306, s_307, s_308
Other pharynx cancer	c_450	s_309, s_310, s_311, s_312
Gallbladder and biliary tract cancer	c_453	s_313, s_314, s_315, s_316
Pancreatic cancer	c_456	s_317, s_318, s_319, s_320
Ovarian cancer	c_465	s_329, s_330, s_331, s_332
Kidney cancer	c_471	s_337, s_338, s_339, s_340
Thyroid cancer	c_480	s_350, s_351, s_352, s_353
Non-hodgkin lymphoma	c_485	s_362, s_363, s_364, s_365
Multiple myeloma	c_486	s_366, s_367, s_368, s_369

Restrictions

The restrictions 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.

For some of the cancer causes in this document, the restrictions differ. So, different tables are used to specify restrictions that are different from others.

The following table describes restrictions of the following cancers:

• Esophageal cancer

• Stomach cancer

• Tracheal, bronchus and lung cancer

• Lip and oral cavity cancer

• Other pharynx cancer

• Gallbladder and biliary tract cancer

• Pancreatic cancer

• Multiple myeloma

Restrictions

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

The following table describes restrictions of the following cancers:

• Cervical cancer

• Uterine cancer

• Ovarian cancer

Restrictions

Restriction Type	Value	Notes
Male only	False
Female only	True
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

The following table describes restrictions of the following cancers:

• Kidney cancer

• Non-hodgkin lymphoma

Restrictions

Restriction Type	Value	Notes
Male only	False
Female only	False
YLL only	False
YLD only	False
YLL age group start	Early Neonatal	GBD age group id 2
YLL age group end	95 plus	GBD age group id 235
YLD age group start	1 to 4	GBD age group id 5
YLD age group end	95 plus	GBD age group id 235

The following table describes restrictions of Nasopharynx cancer:

Restrictions

Restriction Type	Value	Notes
Male only	False
Female only	False
YLL only	False
YLD only	False
YLL age group start	5 to 9	GBD age group id 6
YLL age group end	95 plus	GBD age group id 235
YLD age group start	5 to 9	GBD age group id 6
YLD age group end	95 plus	GBD age group id 235

The following table describes restrictions of Thyroid cancer:

Restrictions

Restriction Type	Value	Notes
Male only	False
Female only	False
YLL only	False
YLD only	False
YLL age group start	10 to 14	GBD age group id 7
YLL age group end	95 plus	GBD age group id 235
YLD age group start	10 to 14	GBD age group id 7
YLD age group end	95 plus	GBD age group id 235

Vivarium Modeling Strategy

Scope

Todo

Add scope.

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.

State and Transition Data Tables

Definitions

State	State Name	Definition
S	Susceptible	Susceptible to cancer
I	Infected	Infected with cancer

States Data

State	Measure	Value	Notes
S	prevalence	1-prevalence_c{cid}	{cid} represents each cancer in the list of cancers modelled in this document
S	excess mortality rate	0
S	disabilty weights	0
I	prevalence	prevalence_c{cid}
I	excess mortality rate	\(\frac{\text{deaths\_c\{cid\}}}{\text{population} \times \text{prevalence\_c\{cid\}}}\)
I	disability weights	\(\displaystyle{\sum_{s\in \text{sequelae\_c\{cid\}}}} \scriptstyle{\text{disability\_weight}_s \,\times\, \text{prevalence}_s}\)	total disability weight over all sequelae corresponding to the cancer
ALL	cause specific mortality rate	\(\frac{\text{deaths\_c\{cid\}}}{\text{population}}\)

Transition Data

Transition	Source	Sink	Value	Notes
i	S	I	\(\frac{\text{incidence\_rate\_c\{cid\}}}{\text{1 - prevalence\_c\{cid\}}}\)	Incidence rate in total population is divided by 1-prevalence_c{cid} to get incidence rate among the susceptible population.

Data Sources

Measure	Sources	Description	Notes
prevalence_c{cid}	como	Prevalence of cause {cancer}	{cancer} represents each cancer in the list of cancers modelled in this document
deaths_c{cid}	codcorrect	Deaths from {cancer}
population	demography	Mid-year population for given country
incidence_rate_c{cid}	como	Incidence rate for {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-Neoplasms]

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)