The Wisconsin Breast Cancer Epidemiology Simulation

Model is a discrete-event, stochastic simulation model using a systems-science modeling approach to replicate breast can-cer incidence and mortality in the U.S. population from 1975 to 2000. Four interacting processes are modeled over time: (1) natural history of breast cancer, (2) breast cancer detec-tion, (3) breast cancer treatment, and (4) competing cause mortality. These components form a complex interacting sys-tem simulating the lives of 2.95 million women (approxi-mately 1/50 the U.S. population) from 1950 to 2000 in 6-month cycles. After a “ burn in ” of 25 years to stabilize prevalent occult cancers, the model outputs age-specifi c incidence rates by stage and age-specifi c mortality rates from 1975 to 2000. The model simulates occult as well as detected disease at the individual level and can be used to address “ What if? ” ques-tions about effectiveness of screening and treatment proto-cols, as well as to estimate benefi ts to women of specifi c age