Breast Cancer Risk Assessment Tools for Stratifying Women into Risk Groups: A Systematic Review.
Cancers (Basel)
; 15(4)2023 Feb 09.
Article
em En
| MEDLINE
| ID: mdl-36831466
ABSTRACT
BACKGROUND:
The benefits and harms of breast screening may be better balanced through a risk-stratified approach. We conducted a systematic review assessing the accuracy of questionnaire-based risk assessment tools for this purpose.METHODS:
Population asymptomatic women aged ≥40 years; Intervention questionnaire-based risk assessment tool (incorporating breast density and polygenic risk where available); Comparison different tool applied to the same population; Primaryoutcome:
breast cancer incidence; Scope external validation studies identified from databases including Medline and Embase (period 1 January 2008-20 July 2021). We assessed calibration (goodness-of-fit) between expected and observed cancers and compared observed cancer rates by risk group. Risk of bias was assessed with PROBAST.RESULTS:
Of 5124 records, 13 were included examining 11 tools across 15 cohorts. The Gail tool was most represented (n = 11), followed by Tyrer-Cuzick (n = 5), BRCAPRO and iCARE-Lit (n = 3). No tool was consistently well-calibrated across multiple studies and breast density or polygenic risk scores did not improve calibration. Most tools identified a risk group with higher rates of observed cancers, but few tools identified lower-risk groups across different settings. All tools demonstrated a high risk of bias.CONCLUSION:
Some risk tools can identify groups of women at higher or lower breast cancer risk, but this is highly dependent on the setting and population.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Idioma:
En
Revista:
Cancers (Basel)
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Austrália