HSPH Researcher Kuntz Simulates Disease Trends with Massive Mathematical Models
Among the first things one spots in Karen Kuntz's office are the multi-colored scrawls that cover a large white board fastened to a wall. From a few feet away, the marks resemble hieroglyphics, with symbols, numbers, and arrows filling the space. And in fact the marks do represent a story of Kuntz's research where numbers and science intersect in a most important way.
Kuntz is an associate professor of health decision science in the Department of Health Policy and Management. She develops mathematical models to simulate the development of diseases, creating "virtual" populations of humans whose characteristics closely match those of real people. With these models, Kuntz and other researchers can help determine who is at risk for disease and how changes to risk factors such as diet and exercise can affect long-term health outcomes.
Kuntz
is currently developing a model to evaluate trends in colorectal cancer
incidence and mortality. Nearly 50,000 Americans die each year from the
disease, despite the fact that more than half of colorectal cancers could
potentially be prevented through lifestyle changes and routine screening.
The mathematical model Kuntz is developing is nothing less than monumental. Using census data, she is constructing a population that mirrors the US. The virtual people will be assigned characteristics, such as smoking or dietary habits, based on national data, in addition to things such as age, sex, and race.
All known risk factors for colorectal cancer will be included in the model. To estimate the effects of these risk factors on the underlying progression of colorectal disease, Kuntz is using data from two major epidemiological studies: the Nurses' Health Study and the Health Professionals Follow-up Study.
The model will include people who have underlying cancer precursors called adenomatous polyps, and will follow them until some of the polyps in Kuntz's virtual patients become cancerous.
The number of people who are diagnosed and die from colorectal cancer, broken down by demographic groups, will then be simulated. This will allow Kuntz to analyze how screening, interventions, and treatments at various points in the progression of the disease might impact the outcome.
For example, scientists have shown that taking aspirin every day decreases the incidence of colorectal cancer, but this strategy is most effective if aspirins are taken in the early stages of the disease. The pills are better at preventing the emergence of a polyp than its progression to cancer.
"This understanding has treatment implications," said Kuntz. "We need to explore the effect of interventions that target different stages of the latent progression of the disease."
Kuntz has worked on about a dozen health topics such as heart disease and asthma, but colorectal cancer intrigues her because it is one of the few cancers that can be staved off by removing the polyps.
"Hopefully, the more research done in this area and the more information that comes out about the value of screening and changing risk factors, the more people we can help," said Kuntz.
Kuntz, an alumna of HSPH, has worked at the school for seven years and
was recently promoted to associate professor.
