Larbi Asamoah, Nyarko Eric, Iddi Samuel
Department of Statistics and Actuarial Science, School of Physical and Mathematical Sciences, University of Ghana, Legon, Accra, Ghana.
African Population and Health Research Center, APHRC Campus, Nairobi, Kenya.
PLOS Glob Public Health. 2025 Jul 28;5(7):e0004953. doi: 10.1371/journal.pgph.0004953. eCollection 2025.
Breast cancer is a disease in which abnormal cells in the breast tissue grow out of control to form tumors and can spread to other parts of the body. While it can affect both men and women, it poses a greater risk to women, and it is a leading cause of cancer-related deaths worldwide. This study aimed to examine different mammography screening interval strategies using a body mass index (BMI)-dependent tumor growth model and a simulation approach. The goal was to identify the optimal screening strategy for various BMI levels by investigating the association between BMI and tumor growth rate, and further examine the relationship between BMI and screening outcomes, using a continuous growth model and Cox regression, respectively. Our results indicated that a biennial screening interval yielded the best outcomes for all BMI levels compared to annual and triennial strategies. Obese individuals may require higher screening sensitivity and are likely to benefit from shorter screening intervals than those with other body weights within the screening age range of 30 to 65 years. Additionally, obese individuals have a slightly higher risk of being diagnosed with interval-detected cancers rather than screen-detected cancers. In contrast, women with a normal body weight have a greater chance of being detected through screening rather than at intervals. These findings suggest that breast cancers may become symptomatic more quickly in obese individuals than in those with lower body weights. Consequently, the standard two-year screening interval may not be optimal for this group, indicating that more frequent screenings (14-18 months) could be necessary. This underscores the potential impact of improved screening practices to enhance the treatment and management of breast cancer.
乳腺癌是一种乳腺组织中的异常细胞失控生长形成肿瘤并可扩散至身体其他部位的疾病。虽然男性和女性都可能患乳腺癌,但女性患病风险更高,它是全球癌症相关死亡的主要原因之一。本研究旨在使用依赖体重指数(BMI)的肿瘤生长模型和模拟方法来检验不同的乳房X光筛查间隔策略。目标是通过研究BMI与肿瘤生长速率之间的关联,分别使用连续生长模型和Cox回归,确定针对不同BMI水平的最佳筛查策略,并进一步研究BMI与筛查结果之间的关系。我们的结果表明,与每年和每三年的筛查策略相比,每两年的筛查间隔对所有BMI水平都产生了最佳结果。在30至65岁的筛查年龄范围内,肥胖个体可能需要更高的筛查敏感度,并且可能比其他体重的个体从更短的筛查间隔中受益。此外,肥胖个体被诊断为间隔期发现的癌症而非筛查发现的癌症的风险略高。相比之下,体重正常的女性通过筛查而非间隔期发现癌症的机会更大。这些发现表明,肥胖个体的乳腺癌可能比体重较低的个体更快出现症状。因此,标准的两年筛查间隔可能对该群体并非最佳,这表明可能需要更频繁的筛查(14 - 18个月)。这凸显了改进筛查方法对加强乳腺癌治疗和管理的潜在影响。