PhD defence M.M. (Maaike) Alblas- Van der Meer

The global cancer burden has increased over the past decades and cancer incidence and mortality are expected to spike even further in the future. Hence, specific actions in the area of cancer screening and risk prediction are necessary to change cancer’s course. The overall aim of this thesis was to evaluate ethics, cost-effectiveness, and prediction modeling of cancer screening and treatment. 
We found that patient autonomy should receive additional attention when epigenetic risk-tailored cancer screening is implemented and could be supported by patient decision aids. Next, we found that prophylactic hysterectomy seems a promising strategy to avoid endometrial cancer cases and endometrial cancer related deaths. The optimal age of having prophylactic surgery depends on individuals’ preferences. Furthermore, we showed that only a few models are available to predict endometrial cancer and most developed models have methodological shortcomings, such as the handling of missing data and the lack of internal and external validation. Prediction models should be developed according to proposed guidelines to obtain accurate individual risk estimates that can aid in medical decision making. A combination of cancer prediction and cancer screening might result in more efficient
cancer screening strategies. This could improve patient outcomes and reduce health care expenditure on cancer care.

The public defence will take place at the Prof. Andries Queridoroom, 3rd floor Education Center, Erasmus MC. The ceremony will begin exactly at 10.30 AM. In light of the solemn nature of the ceremony, we recommend that you do not take children under the age of 6 to the first part of the ceremony.