Louro Javier, Román Marta, Moshina Nataliia, Olstad Camilla F, Larsen Marthe, Sagstad Silje, Castells Xavier, Hofvind Solveig
Department of Epidemiology and Evaluation, Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain.
Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 48902 Barakaldo, Spain.
Cancers (Basel). 2023 Sep 12;15(18):4517. doi: 10.3390/cancers15184517.
We aimed to develop and validate a model predicting breast cancer risk for women targeted by breast cancer screening.
This retrospective cohort study included 57,411 women screened at least once in BreastScreen Norway during the period from 2007 to 2019. The prediction model included information about age, mammographic density, family history of breast cancer, body mass index, age at menarche, alcohol consumption, exercise, pregnancy, hormone replacement therapy, and benign breast disease. We calculated a 4-year absolute breast cancer risk estimates for women and in risk groups by quartiles. The Bootstrap resampling method was used for internal validation of the model (E/O ratio). The area under the curve (AUC) was estimated with a 95% confidence interval (CI).
The 4-year predicted risk of breast cancer ranged from 0.22-7.33%, while 95% of the population had a risk of 0.55-2.31%. The thresholds for the quartiles of the risk groups, with 25% of the population in each group, were 0.82%, 1.10%, and 1.47%. Overall, the model slightly overestimated the risk with an E/O ratio of 1.10 (95% CI: 1.09-1.11) and the AUC was 62.6% (95% CI: 60.5-65.0%).
This 4-year risk prediction model showed differences in the risk of breast cancer, supporting personalized screening for breast cancer in women aged 50-69 years.
我们旨在开发并验证一种针对乳腺癌筛查目标女性的乳腺癌风险预测模型。
这项回顾性队列研究纳入了2007年至2019年期间在挪威乳腺癌筛查项目中至少接受过一次筛查的57411名女性。该预测模型纳入了年龄、乳房X线密度、乳腺癌家族史、体重指数、初潮年龄、饮酒情况、运动、怀孕、激素替代疗法以及良性乳腺疾病等信息。我们计算了女性及按四分位数划分的风险组的4年绝对乳腺癌风险估计值。采用Bootstrap重采样方法对模型进行内部验证（E/O比率）。通过95%置信区间（CI）估计曲线下面积（AUC）。
4年预测乳腺癌风险范围为0.22%-7.33%，而95%的人群风险为0.55%-2.31%。风险组四分位数的阈值，每组占人群的25%，分别为0.82%、1.10%和1.47%。总体而言，该模型略微高估了风险，E/O比率为1.10（95%CI：1.09-1.11），AUC为62.6%（95%CI：60.5-65.0%）。
这种4年风险预测模型显示了乳腺癌风险的差异，支持对50-69岁女性进行个性化乳腺癌筛查。
