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Munoz D, Near AM, van Ravesteyn NT, Lee SJ, Schechter CB, Alagoz O, Berry DA, Burnside ES, Chang Y, Chisholm G, de Koning HJ, Ali Ergun M, Heijnsdijk EAM, Huang H, Stout NK, Sprague BL, Trentham-Dietz A, Mandelblatt JS, Plevritis SK. Effects of screening and systemic adjuvant therapy on ER-specific US breast cancer mortality. J Natl Cancer Inst 2014; 106:dju289. [PMID: 25255803 DOI: 10.1093/jnci/dju289] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Molecular characterization of breast cancer allows subtype-directed interventions. Estrogen receptor (ER) is the longest-established molecular marker. METHODS We used six established population models with ER-specific input parameters on age-specific incidence, disease natural history, mammography characteristics, and treatment effects to quantify the impact of screening and adjuvant therapy on age-adjusted US breast cancer mortality by ER status from 1975 to 2000. Outcomes included stage-shifts and absolute and relative reductions in mortality; sensitivity analyses evaluated the impact of varying screening frequency or accuracy. RESULTS In the year 2000, actual screening and adjuvant treatment reduced breast cancer mortality by a median of 17 per 100000 women (model range = 13-21) and 5 per 100000 women (model range = 3-6) for ER-positive and ER-negative cases, respectively, relative to no screening and no adjuvant treatment. For ER-positive cases, adjuvant treatment made a higher relative contribution to breast cancer mortality reduction than screening, whereas for ER-negative cases the relative contributions were similar for screening and adjuvant treatment. ER-negative cases were less likely to be screen-detected than ER-positive cases (35.1% vs 51.2%), but when screen-detected yielded a greater survival gain (five-year breast cancer survival = 35.6% vs 30.7%). Screening biennially would have captured a lower proportion of mortality reduction than annual screening for ER-negative vs ER-positive cases (model range = 80.2%-87.8% vs 85.7%-96.5%). CONCLUSION As advances in risk assessment facilitate identification of women with increased risk of ER-negative breast cancer, additional mortality reductions could be realized through more frequent targeted screening, provided these benefits are balanced against screening harms.
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Affiliation(s)
- Diego Munoz
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Aimee M Near
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Nicolien T van Ravesteyn
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Sandra J Lee
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Clyde B Schechter
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Oguzhan Alagoz
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Donald A Berry
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Elizabeth S Burnside
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Yaojen Chang
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Gary Chisholm
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Harry J de Koning
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Mehmet Ali Ergun
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Eveline A M Heijnsdijk
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Hui Huang
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Natasha K Stout
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Brian L Sprague
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Amy Trentham-Dietz
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Jeanne S Mandelblatt
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS)
| | - Sylvia K Plevritis
- Division of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
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