Ontology highlight
ABSTRACT: Background
The benefits and harms of breast screening may be better balanced through a risk-stratified approach. We conducted a systematic review assessing the accuracy of questionnaire-based risk assessment tools for this purpose.Methods
Population: asymptomatic women aged ≥40 years; Intervention: questionnaire-based risk assessment tool (incorporating breast density and polygenic risk where available); Comparison: different tool applied to the same population; Primary outcome: breast cancer incidence; Scope: external validation studies identified from databases including Medline and Embase (period 1 January 2008-20 July 2021). We assessed calibration (goodness-of-fit) between expected and observed cancers and compared observed cancer rates by risk group. Risk of bias was assessed with PROBAST.Results
Of 5124 records, 13 were included examining 11 tools across 15 cohorts. The Gail tool was most represented (n = 11), followed by Tyrer-Cuzick (n = 5), BRCAPRO and iCARE-Lit (n = 3). No tool was consistently well-calibrated across multiple studies and breast density or polygenic risk scores did not improve calibration. Most tools identified a risk group with higher rates of observed cancers, but few tools identified lower-risk groups across different settings. All tools demonstrated a high risk of bias.Conclusion
Some risk tools can identify groups of women at higher or lower breast cancer risk, but this is highly dependent on the setting and population.
SUBMITTER: Velentzis LS
PROVIDER: S-EPMC9953796 | biostudies-literature | 2023 Feb
REPOSITORIES: biostudies-literature
Velentzis Louiza S LS Freeman Victoria V Campbell Denise D Hughes Suzanne S Luo Qingwei Q Steinberg Julia J Egger Sam S Mann G Bruce GB Nickson Carolyn C
Cancers 20230209 4
<h4>Background</h4>The benefits and harms of breast screening may be better balanced through a risk-stratified approach. We conducted a systematic review assessing the accuracy of questionnaire-based risk assessment tools for this purpose.<h4>Methods</h4>Population: asymptomatic women aged ≥40 years; Intervention: questionnaire-based risk assessment tool (incorporating breast density and polygenic risk where available); Comparison: different tool applied to the same population; Primary outcome: ...[more]