A systematic review and quality assessment of individualised breast cancer risk prediction models.


Journal

British journal of cancer
ISSN: 1532-1827
Titre abrégé: Br J Cancer
Pays: England
ID NLM: 0370635

Informations de publication

Date de publication:
07 2019
Historique:
received: 10 01 2019
accepted: 25 04 2019
pubmed: 23 5 2019
medline: 11 3 2020
entrez: 23 5 2019
Statut: ppublish

Résumé

Individualised breast cancer risk prediction models may be key for planning risk-based screening approaches. Our aim was to conduct a systematic review and quality assessment of these models addressed to women in the general population. We followed the Cochrane Collaboration methods searching in Medline, EMBASE and The Cochrane Library databases up to February 2018. We included studies reporting a model to estimate the individualised risk of breast cancer in women in the general population. Study quality was assessed by two independent reviewers. Results are narratively summarised. We included 24 studies out of the 2976 citations initially retrieved. Twenty studies were based on four models, the Breast Cancer Risk Assessment Tool (BCRAT), the Breast Cancer Surveillance Consortium (BCSC), the Rosner & Colditz model, and the International Breast Cancer Intervention Study (IBIS), whereas four studies addressed other original models. Four of the studies included genetic information. The quality of the studies was moderate with some limitations in the discriminative power and data inputs. A maximum AUROC value of 0.71 was reported in the study conducted in a screening context. Individualised risk prediction models are promising tools for implementing risk-based screening policies. However, it is a challenge to recommend any of them since they need further improvement in their quality and discriminatory capacity.

Sections du résumé

BACKGROUND
Individualised breast cancer risk prediction models may be key for planning risk-based screening approaches. Our aim was to conduct a systematic review and quality assessment of these models addressed to women in the general population.
METHODS
We followed the Cochrane Collaboration methods searching in Medline, EMBASE and The Cochrane Library databases up to February 2018. We included studies reporting a model to estimate the individualised risk of breast cancer in women in the general population. Study quality was assessed by two independent reviewers. Results are narratively summarised.
RESULTS
We included 24 studies out of the 2976 citations initially retrieved. Twenty studies were based on four models, the Breast Cancer Risk Assessment Tool (BCRAT), the Breast Cancer Surveillance Consortium (BCSC), the Rosner & Colditz model, and the International Breast Cancer Intervention Study (IBIS), whereas four studies addressed other original models. Four of the studies included genetic information. The quality of the studies was moderate with some limitations in the discriminative power and data inputs. A maximum AUROC value of 0.71 was reported in the study conducted in a screening context.
CONCLUSION
Individualised risk prediction models are promising tools for implementing risk-based screening policies. However, it is a challenge to recommend any of them since they need further improvement in their quality and discriminatory capacity.

Identifiants

pubmed: 31114019
doi: 10.1038/s41416-019-0476-8
pii: 10.1038/s41416-019-0476-8
pmc: PMC6738106
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

76-85

Subventions

Organisme : Medical Research Council
ID : MC_UU_12017/15
Pays : United Kingdom
Organisme : Chief Scientist Office
ID : SPHSU15
Pays : United Kingdom

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Auteurs

Javier Louro (J)

Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain.
European Higher Education Area (EHEA) Doctoral Programme in Methodology of Biomedical Research and Public Health in Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autónoma de Barcelona (UAB), Bellaterra, Barcelona, Spain.

Margarita Posso (M)

Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. mposso@parcdesalutmar.cat.
Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain. mposso@parcdesalutmar.cat.

Michele Hilton Boon (M)

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.

Marta Román (M)

Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain.

Laia Domingo (L)

Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain.

Xavier Castells (X)

Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain.

María Sala (M)

Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain.

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