||3U01CA253912-02S1 Interpret this number
||Harvard School Of Public Health
||Comparative Modeling to Inform Cervical Cancer Control Policies
Advances in cervical cancer prevention and treatment have resulted in substantial reductions in incidence and
mortality in the United States (US) over the past twenty years. However, even as overall rates improve, Black
women remain at higher risk than White women for cervical cancer incidence, diagnosis at distant stage, and
mortality. Reasons for these persistent disparities are multifactorial, likely resulting from additive failures along
the cancer care continuum, including increased prevalence of predisposing risk factors, lower receipt of
recommended cervical cancer screening, and delays in receipt of treatment after abnormalities are diagnosed.
To make progress in improving cancer care equity, it is essential to delineate the determinants of racial
disparities in cervical cancer incidence and mortality as a first step towards identifying feasible, effective, and
We propose to adapt the Harvard Chan’s cervical cancer model current default “all race” (i.e., population
average) to reflect variations in the disease burden, as well as both screening and vaccination practice
patterns, among Black women in the US.
We will adapt an all-race cervical cancer model by updating key demographic input parameters to reflect Black
women in the US, such as all-cause mortality and hysterectomy rates. We then will perform analyses using our
Black-specific cervical cancer model to identify the main contributors to disparities in cervical cancer incidence
and mortality. Specifically, we will start by changing the values in each of the main categories of parameters
(i.e., natural history, screening practice patterns, treatment patterns) sequentially from the all-race values to the
Black-specific calibrated values to understand how influential each block of parameters is in explaining the
differences in incidence and mortality. Finally, we will use the adapted model to examine the potential for
interventions to alleviate cervical cancer disparities.
This work, led by the Harvard modeling site, will lay the groundwork for comparative modeling across the other
four CISNET-Cervical modeling sites, as well as enable collaboration across the other CISNET cancer sites in
identifying strategies to reduce overall cancer disparities among Black individuals in the US population.
None. See parent grant details.