Skip to main content
Grant Details

Grant Number: 5U01CA199284-04 Interpret this number
Primary Investigator: Meza, Rafael
Organization: University Of Michigan At Ann Arbor
Project Title: Comparative Modeling of Lung Cancer Prevention and Control Policies
Fiscal Year: 2018
Back to top


? DESCRIPTION (provided by applicant): Lung cancer is the top cancer killer and smoking remains the leading preventable cause of death in the US. Furthermore, major disparities in smoking and lung cancer exist by education, income, and race/ethnicity. While tobacco control policies are the most effective strategies to prevent lung cancers, lung cancer computed tomography (CT) screening has also been shown to reduce lung cancer risk among heavy current and former smokers. The Cancer Intervention and Surveillance Modeling Network (CISNET) lung group develops and applies population models for lung cancer, quantifying the impact of tobacco control and CT screening on lung cancer and all-cause mortality. To date, this work has focused on the country as a whole and has yet to account for tobacco and lung cancer disparities by subgroup and region. This proposed work will extend existing CISNET lung models to investigate the synergistic impacts of tobacco control policies and lung cancer screening in the US and in middle-income nations, focusing on disparities in both smoking behavior and lung cancer risk. The smoking and lung cancer models will incorporate other factors that reflect different smoking risks such as race/ethnicity, education, income, and geographic location. This will allow for analyses of the effects of tobacco control policies on US smoking prevalence in relevant high-risk groups, and estimation of the impact of policies on health disparities in smoking and lung cancer outcomes. Models will also be adapted for two middle-income nations, Mexico and Thailand, to evaluate the impact of tobacco control policies on smoking and lung cancer rates in middle-income countries with different demographic and smoking behavior profiles than the US. Although lung cancer screening is now supported by the USPSTF and other major national organizations, there is still considerable debate over the potential benefits and harms of screening at the population level. This project will extend CISNET lung cancer screening models to assess the consequences of heterogeneity in lung cancer screening implementation, insurance coverage, and compliance with recommended protocols on population health. Models will also be used to investigate the implications of using alternative individual risk prediction measures as eligibility criteria for screening, and to perfom cost-effectiveness analyses of current and alternative screening recommendations, with the goal of identifying optimal strategies at the population level.

Back to top


A spatiotemporal back-calculation approach to estimate cancer incidence measures.
Authors: Nautiyal N. , Holford T.R. .
Source: Statistics In Medicine, 2018-12-20 00:00:00.0; 37(29), p. 4472-4489.
EPub date: 2018-08-28 00:00:00.0.
PMID: 30155939
Related Citations

Smoking and Lung Cancer Mortality in the United States From 2015 to 2065: A Comparative Modeling Approach.
Authors: Jeon J. , Holford T.R. , Levy D.T. , Feuer E.J. , Cao P. , Tam J. , Clarke L. , Clarke J. , Kong C.Y. , Meza R. .
Source: Annals Of Internal Medicine, 2018-10-09 00:00:00.0; , .
EPub date: 2018-10-09 00:00:00.0.
PMID: 30304504
Related Citations

Case Studies of Gastric, Lung, and Oral Cancer Connect Etiologic Agent Prevalence to Cancer Incidence.
Authors: Brouwer A.F. , Eisenberg M.C. , Meza R. .
Source: Cancer Research, 2018-06-15 00:00:00.0; 78(12), p. 3386-3396.
PMID: 29907681
Related Citations

The US SimSmoke tobacco control policy model of smokeless tobacco and cigarette use.
Authors: Levy D.T. , Yuan Z. , Li Y. .
Source: Bmc Public Health, 2018-06-05 00:00:00.0; 18(1), p. 696.
EPub date: 2018-06-05 00:00:00.0.
PMID: 29871597
Related Citations

Identifying Patients for Whom Lung Cancer Screening is Preference-Sensitive: A Microsimulation Study.
Authors: Caverly T.J. , Cao P. , Hayward R.A. , Meza R. .
Source: Annals Of Internal Medicine, 2018-05-29 00:00:00.0; , .
EPub date: 2018-05-29 00:00:00.0.
PMID: 29809244
Related Citations

Re: Think before you leap.
Authors: Han S.S. , Ten Haaf K. , Hazelton W.D. , Jeon J. , Meza R. , Kong C.Y. , Feuer E.J. , de Koning H.J. , Plevritis S.K. .
Source: International Journal Of Cancer, 2018-04-01 00:00:00.0; 142(7), p. 1507-1509.
EPub date: 2017-12-28 00:00:00.0.
PMID: 29194597
Related Citations

Projecting the effects of tobacco control policies in the USA through microsimulation: a study protocol.
Authors: Tam J. , Levy D.T. , Jeon J. , Clarke J. , Gilkeson S. , Hall T. , Feuer E.J. , Holford T.R. , Meza R. .
Source: Bmj Open, 2018-03-23 00:00:00.0; 8(3), p. e019169.
EPub date: 2018-03-23 00:00:00.0.
PMID: 29574440
Related Citations

Population impact of lung cancer screening in the United States: Projections from a microsimulation model.
Authors: Criss S.D. , Sheehan D.F. , Palazzo L. , Kong C.Y. .
Source: Plos Medicine, 2018 Feb; 15(2), p. e1002506.
EPub date: 2018-02-07 00:00:00.0.
PMID: 29415013
Related Citations

The Impact of Implementing Tobacco Control Policies: The 2017 Tobacco Control Policy Scorecard.
Authors: Levy D.T. , Tam J. , Kuo C. , Fong G.T. , Chaloupka F. .
Source: Journal Of Public Health Management And Practice : Jphmp, 2018-01-17 00:00:00.0; , .
EPub date: 2018-01-17 00:00:00.0.
PMID: 29346189
Related Citations

Potential deaths averted in USA by replacing cigarettes with e-cigarettes.
Authors: Levy D.T. , Borland R. , Lindblom E.N. , Goniewicz M.L. , Meza R. , Holford T.R. , Yuan Z. , Luo Y. , O'Connor R.J. , Niaura R. , et al. .
Source: Tobacco Control, 2018 Jan; 27(1), p. 18-25.
EPub date: 2017-10-02 00:00:00.0.
PMID: 28970328
Related Citations

Lung Cancer Mortality Associated With Smoking and Smoking Cessation Among People Living With HIV in the United States.
Authors: Reddy K.P. , Kong C.Y. , Hyle E.P. , Baggett T.P. , Huang M. , Parker R.A. , Paltiel A.D. , Losina E. , Weinstein M.C. , Freedberg K.A. , et al. .
Source: Jama Internal Medicine, 2017-09-18 00:00:00.0; , .
EPub date: 2017-09-18 00:00:00.0.
PMID: 28975270
Related Citations

Risk Stratification for Second Primary Lung Cancer.
Authors: Han S.S. , Rivera G.A. , Tammemägi M.C. , Plevritis S.K. , Gomez S.L. , Cheng I. , Wakelee H.A. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2017-09-01 00:00:00.0; 35(25), p. 2893-2899.
EPub date: 2017-06-23 00:00:00.0.
PMID: 28644772
Related Citations

Evaluating the impact of varied compliance to lung cancer screening recommendations using a microsimulation model.
Authors: Han S.S. , Erdogan S.A. , Toumazis I. , Leung A. , Plevritis S.K. .
Source: Cancer Causes & Control : Ccc, 2017 Sep; 28(9), p. 947-958.
EPub date: 2017-07-12 00:00:00.0.
PMID: 28702814
Related Citations

The Relationship of E-Cigarette Use to Cigarette Quit Attempts and Cessation: Insights From a Large, Nationally Representative U.S. Survey.
Authors: Levy D.T. , Yuan Z. , Luo Y. , Abrams D.B. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2017-08-31 00:00:00.0; , .
EPub date: 2017-08-31 00:00:00.0.
PMID: 29059341
Related Citations

The impact of overdiagnosis on the selection of efficient lung cancer screening strategies.
Authors: Han S.S. , Ten Haaf K. , Hazelton W.D. , Munshi V.N. , Jeon J. , Erdogan S.A. , Johanson C. , McMahon P.M. , Meza R. , Kong C.Y. , et al. .
Source: International Journal Of Cancer, 2017-06-01 00:00:00.0; 140(11), p. 2436-2443.
PMID: 28073150
Related Citations

Risk prediction models for selection of lung cancer screening candidates: A retrospective validation study.
Authors: Ten Haaf K. , Jeon J. , Tammemägi M.C. , Han S.S. , Kong C.Y. , Plevritis S.K. , Feuer E.J. , de Koning H.J. , Steyerberg E.W. , Meza R. .
Source: Plos Medicine, 2017 Apr; 14(4), p. e1002277.
EPub date: 2017-04-04 00:00:00.0.
PMID: 28376113
Related Citations

The Application Of A Decision-theoretic Model To Estimate The Public Health Impact Of Vaporized Nicotine Product Initiation In The United States
Authors: Levy D.T. , Borland R. , Villanti A.C. , Niaura R. , Yuan Z. , Zhang Y. , Meza R. , Holford T.R. , Fong G.T. , Cummings K.M. , et al. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2017 Feb; 19(2), p. 149-159.
PMID: 27613952
Related Citations

Developing Consistent and Transparent Models of E-cigarette Use: Reply to Glantz and Soneji et al.
Authors: Levy D.T. , Borland R. , Fong G.T. , Villanti A.C. , Niaura R. , Meza R. , Holford T.R. , Cummings K.M. , Abrams D.B. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2017 Feb; 19(2), p. 268-270.
EPub date: 2016-10-06 00:00:00.0.
PMID: 28082477
Related Citations

Performance and Cost-Effectiveness of Computed Tomography Lung Cancer Screening Scenarios in a Population-Based Setting: A Microsimulation Modeling Analysis in Ontario, Canada.
Authors: Ten Haaf K. , Tammemägi M.C. , Bondy S.J. , van der Aalst C.M. , Gu S. , McGregor S.E. , Nicholas G. , de Koning H.J. , Paszat L.F. .
Source: Plos Medicine, 2017 Feb; 14(2), p. e1002225.
EPub date: 2017-02-07 00:00:00.0.
PMID: 28170394
Related Citations

The Authors Respond
Authors: Cherng S.T. , Tam J. , Christine P.J. , Meza R. .
Source: Epidemiology (cambridge, Mass.), 2017 Jan; 28(1), p. e1-e2.
PMID: 27682523
Related Citations

Evaluating lung cancer screening in China: Implications for eligibility criteria design from a microsimulation modeling approach.
Authors: Sheehan D.F. , Criss S.D. , Gazelle G.S. , Pandharipande P.V. , Kong C.Y. .
Source: Plos One, 2017; 12(3), p. e0173119.
EPub date: 2017-03-08 00:00:00.0.
PMID: 28273181
Related Citations

Public Health Benefits From Pictorial Health Warnings On Us Cigarette Packs: A Simsmoke Simulation
Authors: Levy D.T. , Mays D. , Yuan Z. , Hammond D. , Thrasher J.F. .
Source: Tobacco Control, 2016-11-02 00:00:00.0; , .
PMID: 27807299
Related Citations

Modeling the Effects of E-cigarettes on Smoking Behavior: Implications for Future Adult Smoking Prevalence.
Authors: Cherng S.T. , Tam J. , Christine P.J. , Meza R. .
Source: Epidemiology (cambridge, Mass.), 2016 Nov; 27(6), p. 819-26.
PMID: 27093020
Related Citations

Methods for individualized assessment of absolute risk in case-control studies should be weighted carefully.
Authors: Haaf K.T. , Steyerberg E.W. .
Source: European Journal Of Epidemiology, 2016 Nov; 31(11), p. 1067-1068.
EPub date: 2016-10-13 00:00:00.0.
PMID: 27738831
Related Citations

The role of public policies in reducing smoking prevalence: results from the Michigan SimSmoke tobacco policy simulation model.
Authors: Levy D.T. , Huang A.T. , Havumaki J.S. , Meza R. .
Source: Cancer Causes & Control : Ccc, 2016 May; 27(5), p. 615-25.
PMID: 26983616
Related Citations

Gauging the Effect of U.S. Tobacco Control Policies From 1965 Through 2014 Using SimSmoke.
Authors: Levy D.T. , Meza R. , Zhang Y. , Holford T.R. .
Source: American Journal Of Preventive Medicine, 2016 Apr; 50(4), p. 535-42.
PMID: 26673484
Related Citations

Comparison of Smoking History Patterns Among African American and White Cohorts in the United States Born 1890 to 1990.
Authors: Holford T.R. , Levy D.T. , Meza R. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2016 Apr; 18 Suppl 1, p. S16-29.
PMID: 26980861
Related Citations

Evaluating the impacts of screening and smoking cessation programmes on lung cancer in a high-burden region of the USA: a simulation modelling study.
Authors: Tramontano A.C. , Sheehan D.F. , McMahon P.M. , Dowling E.C. , Holford T.R. , Ryczak K. , Lesko S.M. , Levy D.T. , Kong C.Y. .
Source: Bmj Open, 2016-02-29 00:00:00.0; 6(2), p. e010227.
EPub date: 2016-02-29 00:00:00.0.
PMID: 26928026
Related Citations

Mexico SimSmoke: how changes in tobacco control policies would impact smoking prevalence and smoking attributable deaths in Mexico.
Authors: Fleischer N.L. , Thrasher J.F. , Reynales-Shigematsu L.M. , Cummings K.M. , Meza R. , Zhang Y. , Levy D.T. .
Source: Global Public Health, 2016-02-02 00:00:00.0; , p. 1-16.
EPub date: 2016-02-02 00:00:00.0.
PMID: 26837721
Related Citations

Clarifying Assumptions and Outcomes in Cost-effectiveness Analyses.
Authors: ten Haaf K. , de Koning H.J. .
Source: Jama Oncology, 2016 Feb; 2(2), p. 277-8.
PMID: 26869001
Related Citations

Overdiagnosis in lung cancer screening: why modelling is essential.
Authors: Ten Haaf K. , de Koning H.J. .
Source: Journal Of Epidemiology And Community Health, 2015 Nov; 69(11), p. 1035-9.
PMID: 26071497
Related Citations

Age-Period-Cohort approaches to back-calculation of cancer incidence rate.
Authors: Oh C. , Holford T.R. .
Source: Statistics In Medicine, 2015-05-20 00:00:00.0; 34(11), p. 1953-64.
EPub date: 2015-05-20 00:00:00.0.
PMID: 25715831
Related Citations

Back to Top