Washington University School of Medicine, St. Louis, Missouri.
Kent State University, Kent, Ohio.
Cancer Epidemiol Biomarkers Prev. 2020 Dec;29(12):2389-2394. doi: 10.1158/1055-9965.EPI-20-0861. Epub 2020 Oct 12.
Cancer risk prediction models such as those published in are a cornerstone of precision medicine and public health efforts to improve population health outcomes by tailoring preventive strategies and therapeutic treatments to the people who are most likely to benefit. However, there are several barriers to the effective translation, dissemination, and implementation of cancer risk prediction models into clinical and public health practice. In this commentary, we discuss two broad categories of barriers. Specifically, we assert that the successful use of risk-stratified cancer prevention and treatment strategies is particularly unlikely if risk prediction models are translated into risk assessment tools that (i) are difficult for the public to understand or (ii) are not structured in a way to engender the public's confidence that the results are accurate. We explain what aspects of a risk assessment tool's design and content may impede understanding and acceptance by the public. We also describe strategies for translating a cancer risk prediction model into a cancer risk assessment tool that is accessible, meaningful, and useful for the public and in clinical practice.
癌症风险预测模型,如在 中发表的那些,是精准医学和公共卫生努力的基石,旨在通过针对最有可能受益的人群定制预防策略和治疗方法来改善人口健康结果。然而,癌症风险预测模型在有效转化为临床和公共卫生实践方面存在几个障碍。在这篇评论中,我们讨论了两大类障碍。具体来说,我们断言,如果风险预测模型转化为以下风险评估工具,那么风险分层的癌症预防和治疗策略的成功使用尤其不太可能:(i) 公众难以理解,或 (ii) 没有以一种让公众相信结果准确的方式构建。我们解释了风险评估工具的设计和内容的哪些方面可能会阻碍公众的理解和接受。我们还描述了将癌症风险预测模型转化为公众和临床实践中可访问、有意义和有用的癌症风险评估工具的策略。