Modeling cancer detection: tumor size as a source of information on unobservable stages of carcinogenesis

This paper is concerned with modern approaches to mechanistic modeling of t he process of cancer detection. Measurements of tumor size at diagnosis rep resent a valuable source of information to enrich statistical inference on the processes underlying tumor latency. One possible way of utilizing this information is to model cancer detection as a quantal response variable. In doing so, one relates the chance of detecting a tumor to its current size. We present various theoretical results emerging from this approach and ill ustrate their usefulness with numerical examples and analyses of epidemiolo gical data. An alternative approach based on a threshold type mechanism of tumor detection is briefly described. (C) 2001 Elsevier Science Inc. All ri ghts reserved.