Comparing 5-Year and Lifetime Risks of Breast Cancer using the Prospective Family Study Cohort

被引:10
|
作者
MacInnis, Robert J. [1 ,2 ]
Knight, Julia A. [3 ,4 ]
Chung, Wendy K. [5 ,6 ,7 ]
Milne, Roger L. [1 ,2 ,8 ]
Whittemore, Alice S. [9 ]
Buchsbaum, Richard [10 ]
Liao, Yuyan [11 ]
Zeinomar, Nur [11 ]
Dite, Gillian S. [2 ]
Southey, Melissa C. [1 ,8 ,12 ]
Goldgar, David [13 ,14 ]
Giles, Graham G. [1 ,2 ,15 ]
Kurian, Allison W. [16 ]
Investigators, KConFab [17 ,18 ]
Andrulis, Irene L. [3 ,19 ,20 ]
John, Esther M. [21 ,22 ]
Daly, Mary B. [23 ]
Buys, Saundra S. [14 ,24 ]
Phillips, Kelly-Anne [2 ,17 ,25 ]
Hopper, John L. [2 ]
Terry, Mary Beth [5 ,11 ]
机构
[1] Canc Council Victoria, Canc Epidemiol Div, 615 St Kilda Rd, Melbourne, Vic 3004, Australia
[2] Univ Melbourne, Ctr Epidemiol & Biostat, Parkville, Vic, Australia
[3] Sinai Hlth Syst, Lunenfeld Tanenbaum Res Inst, Toronto, ON, Canada
[4] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada
[5] Columbia Univ, Med Ctr, Herbert Irving Comprehens Canc Ctr, New York, NY USA
[6] Columbia Univ, Dept Pediat, New York, NY 10027 USA
[7] Columbia Univ, Dept Med, New York, NY USA
[8] Monash Univ, Sch Clin Sci Monash Hlth, Precis Med, Clayton, Vic, Australia
[9] Stanford Univ, Sch Med, Dept Hlth Res & Policy & Biomed Data Sci, Stanford, CA USA
[10] Columbia Univ, Mailman Sch Publ Hlth, Dept Biostat, New York, NY USA
[11] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY USA
[12] Univ Melbourne, Dept Pathol, Genet Epidemiol Lab, Parkville, Vic, Australia
[13] Univ Utah Hlth, Dept Dermatol, Salt Lake City, UT USA
[14] Univ Utah Hlth, Huntsman Canc Inst, Salt Lake City, UT USA
[15] Monash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic, Australia
[16] Stanford Univ, Dept Med & Epidemiol & Populat Hlth, Stanford, CA 94305 USA
[17] Univ Melbourne, Sir Peter MacCallum Dept Oncol, Melbourne, Vic, Australia
[18] Peter MacCallum Canc Ctr, Res Dept, Melbourne, Vic, Australia
[19] Univ Toronto, Dept Mol Genet, Toronto, ON, Canada
[20] Univ Toronto, Lab Med & Pathobiol, Toronto, ON, Canada
[21] Stanford Univ, Sch Med, Dept Epidemiol & Populat Hlth & Med, Stanford, CA USA
[22] Stanford Univ, Sch Med, Stanford Canc Inst, Stanford, CA USA
[23] Fox Chase Canc Ctr, Dept Clin Genet, 7701 Burholme Ave, Philadelphia, PA 19111 USA
[24] Univ Utah Hlth, Dept Med, Salt Lake City, UT USA
[25] Peter MacCallum Canc Ctr, Dept Med Oncol, Melbourne, Vic, Australia
来源
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2021年 / 113卷 / 06期
基金
英国医学研究理事会;
关键词
SOCIETY GUIDELINES; REGISTRY;
D O I
10.1093/jnci/djaa178
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Clinical guidelines often use predicted lifetime risk from birth to define criteria for making decisions regarding breast cancer screening rather than thresholds based on absolute 5-year risk from current age. Methods: We used the Prospective Family Cohort Study of 14 657 women without breast cancer at baseline in which, during a median follow-up of 10 years, 482 women were diagnosed with invasive breast cancer. We examined the performances of the International Breast Cancer Intervention Study (IBIS) and Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) risk models when using the alternative thresholds by comparing predictions based on 5-year risk with those based on lifetime risk from birth and remaining lifetime risk. All statistical tests were 2-sided. Results: Using IBIS, the areas under the receiver-operating characteristic curves were 0.66 (95% confidence interval = 0.63 to 0.68) and 0.56 (95% confidence interval = 0.54 to 0.59) for 5-year and lifetime risks, respectively (P-diff < .001). For equivalent sensitivities, the 5-year incidence almost always had higher specificities than lifetime risk from birth. For women aged 20-39 years, 5-year risk performed better than lifetime risk from birth. For women aged 40 years or older, receiver-operating characteristic curves were similar for 5-year and lifetime IBIS risk from birth. Classifications based on remaining lifetime risk were inferior to 5-year risk estimates. Results were similar using BOADICEA. Conclusions: Our analysis shows that risk stratification using clinical models will likely be more accurate when based on predicted 5-year risk compared with risks based on predicted lifetime and remaining lifetime, particularly for women aged 20-39 years.
引用
收藏
页码:785 / 791
页数:7
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