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在实施风险分层背景下关于乳腺癌筛查与预防的建议:现行政策即将发生的变化。

Recommendations on breast cancer screening and prevention in the context of implementing risk stratification: impending changes to current policies.

作者信息

Gagnon J, Lévesque E, Borduas F, Chiquette J, Diorio C, Duchesne N, Dumais M, Eloy L, Foulkes W, Gervais N, Lalonde L, L'Espérance B, Meterissian S, Provencher L, Richard J, Savard C, Trop I, Wong N, Knoppers B M, Simard J

机构信息

Montreal, QC: Centre of Genomics and Policy, Department of Human Genetics, McGill University (Gagnon, Lévesque, Knoppers); Quebec Breast Cancer Foundation [Dumais (observing member)]; Sir Mortimer B. Davis Jewish General Hospital and McGill University Health Centre (Foulkes); Breast Imaging Centre, Centre hospitalier de l'Université de Montréal (Lalonde, Trop); Hôpital du Sacré-Coeur de Montréal and Groupe d'Étude en Oncologie du Québec (L'Espérance); Royal Victoria Hospital and Cedars Breast Clinic of the McGill University Health Centre (Meterissian); Centre Intégré en traitement, recherche et enseignement en Cancer du Sein, Centre hospitalier de l'Université de Montréal (Richard); Sir Mortimer B. Davis Jewish General Hospital and McGill University (Wong).

Quebec City, QC: Public Health Branch, Capitale-Nationale (Borduas); Centre hospitalier universitaire ( chu ) de Québec-Université Laval (Chiquette, Duchesne, Provencher); Centre de coordination des services régionaux, Capitale-Nationale (Chiquette); Quebec Breast Cancer Screening Program (Chiquette, Eloy); chu de Québec-Université Laval Research Center and Department of Social and Preventive Medicine, Université Laval (Diorio); Cancer Branch, Ministry of Health and Social Services (Eloy); Deschênes-Fabia Breast Diseases Center (Provencher); chu de Québec-Université Laval (Duchesne); Canada Research Chair in Oncogenetics, chu de Québec-Université Laval Research Centre, and Department of Molecular Medicine, Université Laval (Simard).

出版信息

Curr Oncol. 2016 Dec;23(6):e615-e625. doi: 10.3747/co.23.2961. Epub 2016 Dec 21.

Abstract

In recent years, risk stratification has sparked interest as an innovative approach to disease screening and prevention. The approach effectively personalizes individual risk, opening the way to screening and prevention interventions that are adapted to subpopulations. The international perspective project, which is developing risk stratification for breast cancer, aims to support the integration of its screening approach into clinical practice through comprehensive tool-building. Policies and guidelines for risk stratification-unlike those for population screening programs, which are currently well regulated-are still under development. Indeed, the development of guidelines for risk stratification reflects the translational aspects of perspective. Here, we describe the risk stratification process that was devised in the context of perspective, and we then explain the consensus-based method used to develop recommendations for breast cancer screening and prevention in a risk-stratification approach. Lastly, we discuss how the recommendations might affect current screening policies.

摘要

近年来,风险分层作为一种疾病筛查和预防的创新方法引发了人们的关注。该方法有效地实现了个体风险的个性化,为适用于亚人群的筛查和预防干预措施开辟了道路。正在开展乳腺癌风险分层研究的国际视角项目旨在通过全面的工具构建,支持将其筛查方法纳入临床实践。与目前监管完善的人群筛查项目政策和指南不同,风险分层的政策和指南仍在制定中。事实上,风险分层指南的制定反映了视角的转化方面。在此,我们描述了在该视角背景下设计的风险分层过程,然后解释了用于以风险分层方法制定乳腺癌筛查和预防建议的基于共识的方法。最后,我们讨论这些建议可能如何影响当前的筛查政策。

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