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020 ▼a 9781085646093
035 ▼a (MiAaPQ)AAI27529093
035 ▼a (MiAaPQ)NCState_Univ18402036866
040 ▼a MiAaPQ ▼c MiAaPQ ▼d 247004
0820 ▼a 001
1001 ▼a Abu-El-Haija, Lena A,.
24510 ▼a PRECiSE: PancREatic Cancer Prioritization and Screening Evaluation Tool.
260 ▼a [S.l.]: ▼b North Carolina State University., ▼c 2019.
260 1 ▼a Ann Arbor: ▼b ProQuest Dissertations & Theses, ▼c 2019.
300 ▼a 129 p.
500 ▼a Source: Dissertations Abstracts International, Volume: 81-03, Section: B.
500 ▼a Advisor: Hicklin, Karen
5021 ▼a Thesis (Ph.D.)--North Carolina State University, 2019.
506 ▼a This item must not be sold to any third party vendors.
520 ▼a Pancreatic cancer (PC) is the fourth leading cause of death due to cancer in the US, and it is projected to be the second leading cause by 2030. While the incidence of PC is relatively low, it has been increasing in recent years. The mortality risk of PC is high with an 8% five-year survival rate. PC can be asymptomatic, which often leads to late diagnosis after the tumor has metastasized to other organs. The late diagnosis was initially perceived to be due to the tumor's rapid progression. However, recent findings have shown that there is an average of seven years from the start of the tumor until metastasis. This presents an opportunity for screening to detect PC patients earlier. Chapter 2 presents a discrete event simulation model of pancreatic cancer progression, where the discrete events are (i) tumor volume at symptomatic detection, (ii) tumor volume at transition from the local stage to the regional stage, and (iii) tumor volume at transition from the regional stage to the distant stage. The model is personalized to race, gender, and age. Surveillance, Epidemiology and End Results data were used to parameterize the model. Pancreatic cancer is resectable if the tumor can be surgically removed. Resection is the best option for improving survival rates. In Chapter 2, a resectability prediction tool is introduced. With resection being the only true cure for PC, there is a call for screening policies to catch the disease at an early stage. However, current screening policies remain nonspecific with undetermined screening start age, screening interval, and screening end age. The general population has a lifetime risk of 1.3%. However, some are at a much higher risk than others. There are calls for PC screening of high-risk patients only rather than a population wide screening. The International Cancer of the Pancreas Screening Consortium defines high-risk as genetic mutation or first-degree family members with PC. In Chapter 3, we present an extension to the progression model from Chapter 2, where the risk of a patient contributes to the incidence rate of PC. We overlay the progression model with different screening policies, where the screening start age is set at 50 years old, the screening end age is set at 100, and the screening interval was set at half a year, a year, two years, three years, four years, five years, and ten years. We created different homogeneous populations to study the effect of the screening policies and the effort associated with catching one pancreatic cancer by screening by race, gender, and patient PC risk. In Chapter 4, we expand the resectability prediction tool and integrate it with the screening model. We test screening policies with varying screening start age, screening end age, screening interval, and screening modality. We test the different policies on homogeneous and heterogeneous populations. We estimate the effort to screen and the average five-year survival of each policy. We create an effort to five-year survival frontier and identify the efficient policies.
590 ▼a School code: 0155.
650 4 ▼a Biomedical engineering.
650 4 ▼a Oncology.
650 4 ▼a Medical imaging.
650 4 ▼a Systems science.
690 ▼a 0992
690 ▼a 0574
690 ▼a 0541
690 ▼a 0790
71020 ▼a North Carolina State University.
7730 ▼t Dissertations Abstracts International ▼g 81-03B.
773 ▼t Dissertation Abstract International
790 ▼a 0155
791 ▼a Ph.D.
792 ▼a 2019
793 ▼a English
85640 ▼u http://www.riss.kr/pdu/ddodLink.do?id=T15494132 ▼n KERIS ▼z 이 자료의 원문은 한국교육학술정보원에서 제공합니다.
980 ▼a 202002 ▼f 2020
990 ▼a ***1816162
991 ▼a E-BOOK