Computer models fill critical knowledge gaps to help reduce cancer disparities

Dec. 1, 2023
Special issue of JNCI looks at how modeling can help achieve equity in cancer outcomes.

Reducing health disparities in incidence and mortality for major types of cancers can be aided by sophisticated computer modeling efforts, according to new, wide-ranging perspectives from researchers at Georgetown University’s Lombardi Comprehensive Cancer Center and colleagues around the country. The collection of articles appears in the November 8, 2023, special issue of JNCI and are devoted to outlining a path forward in cancer disparities modeling. 

The studies in JNCI used modeling to synthesize data specifically for the overall U.S. population compared to the U.S. Black population to quantify the contributions of different aspects of cancer care to the impact on disparities in cancer mortality.

Given the high cost and long time periods needed to obtain results from clinical trials looking at interventions to prevent and treat many cancers and the chronic lack of sufficient enrollment of Black people in these trials, simulating cancer outcomes in diverse populations with sophisticated computer modeling tools is recommended by the National Academy of Sciences and others as a high-quality alternative assessment method. To that end, the Cancer Intervention and Surveillance Modeling Network (CISNET) has been funded by the National Cancer Institute, a part of the National Institutes of Health, since the year 2000 to advance modeling science for the disease.

The CISNET studies in this issue of JNCI considered an antiracism framework that aims to identify strategies to advance health equity among Black people and other populations underrepresented in medical research. The authors define health equity as “the absence of unfair, avoidable or remediable differences in health outcomes so that no one is disadvantaged by socioeconomics or other factors.”

Significantly, the researchers were able to confirm that CISNET modeled incidence and mortality rates closely matched observed cancer statistical trends over time, lending validity to the modeling approach.

Taken together, the results of the modeling analyses included several notable patterns:

·        In cancers with widely used screening procedures but persistently large gaps in racial incidence, better access to screening by racial minorities could play a larger role in helping reduce those disparities.

·        High-quality therapies (those in accordance with treatment recommendations from professional organizations with treatment guidelines delivered promptly after diagnosis, with all planned cycles completed and no or minimal dose reductions) could have a very positive impact on mortality disparities between Black people compared to the overall population, especially as new and more effective therapeutic options evolve.

Georgetown University’s Lombardi Comprehensive Cancer Center release on Newswise