Patient model for colon and colorectal cancer care trajectory simulation

Almost half Canadians (41% women and 46% men) will develop cancer during their lifetime and 88% of them are older than fifty [1]. Lung, breast, colon, colorectal and prostate cancers represent more than half of all new cancer cases (52%). Breast cancer is the leading type of cancer among women, while colon and colorectal cancer are the third most common cancer among men and women. Cancer is the leading cause of death in Canada and in the world with 29.8% of the population affected, compared to 26.6% for cardiovascular diseases [2]. Furthermore, in 2000, cancer was the fourth most expensive disease in Canada with $17.4 billion spent. Colon and Colorectal cancer are considered the second leading cause of cancer death among men and the third among women.

Cancer treatment is characterized by the convergence of many services including ambulatory, hospitals, clinical, nutritional, psychological, and sports medicine, which coordination and integration condition treatment success and patient quality of life. In order to reduce the impact of this disease and increase the cure rate and the patient quality of life, it is necessary to develop and evaluate new therapeutic and organizational approaches. This study deals with this goal and is the first methodological step toward creating a simulation platform of care trajectories of colorectal cancer patients. This simulation platform aims at simulating many elements of the hospital environment, from care resources to patient physiology and psychology profiles, in order to evaluate the many impacts of organizational changes of care trajectories.

First, this paper describes the general scope of this simulation project and presents a state of the art of agentbased simulation. Next, the general conceptual model of the simulation is described. Then, we present our cancer evolution, which is then tested and validated using two separate experiments.

Mots clés

Agent-based simulation; Cancer evolution model; Colon cancer; Colorectal cancer; Virtual patient