标题：A systematic review of international simulation models on the natural history of breast cancer: Current understanding and challenges for Chinese-population-specific model development
作者：Ma H.; Wang I.; Shi J.; Ying J.; Zhu J.; Chen I.; Yue X.; Gong J.;等 更多 作者机构：[Ma, H] Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Uni 更多
通讯作者地址：[Shi, J] Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Un 更多
来源：Chinese Journal of Endemiology
关键词：Breast neoplasms; Modelling; Natural history; Systematic review
摘要：Objective To systematically review the worldwide simulation model studies on the natural history of breast cancer and to summarize related parameters. Methods A structured literature search was conducted in PubMed and the Cochrane Library to identify articles during 1980-2015. Articles were screened independently by two researchers. Health states in the natural history and relevant parameters were extracted. Results A total of 36 studies were included for analysis, within the earliest one was published in 1990. Most studies were from Europe and America countries, and 2 studies from China. Markov model was mostly applied to evaluating breast canccr screening programs (n=32). Reported health status included "healthy" (n=36), ductal carcinoma in situ (DCIS, = 17), invasive breast cancer (IBC, n=36), and death (n=27). There were two definite classifications for IBC, tumor size (n=9) and TNM staging (n=9, 3 studies reported transition rates). The median (range) of annual transition rates from DCIS to stage- I IBC, I to II, II to III, III to IV were 0.279 (0.259-0.299), 0.150 (0.069-0.430), 0.100 (0.060-0.128) and 0210 (0.010-0.625), respectively. A total of 15 studies reported the mean duration from predinical to clinical stage for IBC was 1.95-4.70 years, which gradually increased with age, and 7 studies reported that for DCIS. Conclusions Despite closer attention was paid to breast cancer natural history models, in recent years atypical hyperplasia has been neglected. Data on the mean duration of DCIS requires reasonable conversion. Various classifications for IBC exist whereas transition rates arc limited. Current findings would be valuable references but challenging for the Chinese-population specific natural history model, development. © 2017 Chinese Medical Association. All rights reserved.