Cancer Center, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
Cancer Center, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA.
BMJ Open. 2022 Dec 9;12(12):e061205. doi: 10.1136/bmjopen-2022-061205.
To develop a breast cancer risk prediction model for Chamorro and Filipino women of the Mariana Islands and compare its performance to that of the Breast Cancer Risk Assessment Tool (BCRAT).
Case-control study.
Clinics/facilities and other community-based settings on Guam and Saipan (Northern Mariana Islands).
245 women (87 breast cancer cases and 158 controls) of Chamorro or Filipino ethnicity, age 25-80 years, with no prior history of cancer (other than skin cancer), residing on Guam or Saipan for at least 5 years.
Breast cancer risk models were constructed using combinations of exposures previously identified to affect breast cancer risk in this population, population breast cancer incidence rates and all-cause mortality rates for Guam.
Models using ethnic-specific relative risks performed better than those with relative risks estimated from all women. The model with the best performance among both ethnicities (the Breast Cancer Risk Model (BRISK) model; area under the receiver operating characteristic curve (AUC): 0.64 and 0.67 among Chamorros and Filipinos, respectively) included age at menarche, age at first live birth, number of relatives with breast cancer and waist circumference. The 10-year breast cancer risk predicted by the BRISK model was 1.28% for Chamorros and 0.89% for Filipinos. Performance of the BCRAT was modest among both Chamorros (AUC: 0.60) and Filipinos (AUC: 0.55), possibly due to incomplete information on BCRAT risk factors.
The ability to develop breast cancer risk models for Mariana Islands women is constrained by the small population size and limited availability of health services and data. Nonetheless, we have demonstrated that breast cancer risk prediction models with adequate discriminatory performance can be built for small populations such as in the Mariana Islands. Anthropometry, in particular waist circumference, was important for estimating breast cancer risk in this population.
为马里亚纳群岛的查莫罗人和菲律宾裔女性开发乳腺癌风险预测模型，并将其性能与乳腺癌风险评估工具（BCRAT）进行比较。
病例对照研究。
关岛和塞班岛（北马里亚纳群岛）的诊所/医疗机构和其他社区场所。
245 名查莫罗或菲律宾裔女性（87 例乳腺癌病例和 158 例对照），年龄 25-80 岁，无癌症（除皮肤癌外）既往史，在关岛或塞班岛居住至少 5 年。
使用先前确定的影响该人群乳腺癌风险的暴露组合、关岛人群乳腺癌发病率和全因死亡率构建乳腺癌风险模型。
使用特定于族裔的相对风险的模型表现优于使用所有女性估计的相对风险的模型。两种族裔中表现最好的模型（乳腺癌风险模型（BRISK）模型；在查莫罗人和菲律宾人中，接受者操作特征曲线下的面积（AUC）分别为 0.64 和 0.67）包括初潮年龄、首次活产年龄、有乳腺癌亲属的人数和腰围。BRISK 模型预测的 10 年乳腺癌风险分别为查莫罗人 1.28%和菲律宾人 0.89%。BRISK 在查莫罗人中（AUC：0.60）和菲律宾人中（AUC：0.55）的表现都很适中，这可能是由于 BCRAT 风险因素的信息不完整。
为马里亚纳群岛女性开发乳腺癌风险模型的能力受到人口规模小、卫生服务和数据有限的限制。尽管如此，我们已经证明，对于像马里亚纳群岛这样的小人群，具有足够区分性能的乳腺癌风险预测模型是可以建立的。在该人群中，人体测量学，特别是腰围，对于估计乳腺癌风险很重要。
