On the optimal policies of cancer screening

Some problems of optimal screening are considered. A screening strategy is allowed to be nonperiodic. Two approaches to screening optimization are used: the minimum delay time approach and the minimum cost approach. Both approaches are applied to the analysis of an optimization problem when the natu...

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Bibliographic Details
Published in:Mathematical biosciences 1991-11, Vol.107 (1), p.21-45
Main Authors: Tsodikov, Alexander D., Yakovlev, Andrej Yu
Format: Article
Language:English
Subjects:
Biological and medical sciences
Computerized, statistical medical data processing and models in biomedicine
Costs and Cost Analysis
Humans
Mass Screening - economics
Mass Screening - methods
Medical sciences
Models, Theoretical
Neoplasms - prevention & control
Time Factors
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Summary:Some problems of optimal screening are considered. A screening strategy is allowed to be nonperiodic. Two approaches to screening optimization are used: the minimum delay time approach and the minimum cost approach. Both approaches are applied to the analysis of an optimization problem when the natural history of the disease is known and when it is unknown (a minimax problem). The structure of optimal screening policies is investigated as well as the benefit they can provide compared to the periodic screening policy. The detection probability is assumed to depend only on the stage of the disease, though it may not be constant throughout each stage. It is shown that periodic screening appears to be optimal when one has no information on the natural history of the disease, the minimum delay time criterion being used for optimization. Some applications to lung cancer screening are presented.
ISSN:0025-5564
1879-3134
DOI:10.1016/0025-5564(91)90070-Y