@article{pmid34743725,

title = {Polygenic risk score across distinct colorectal cancer screening outcomes: from premalignant polyps to colorectal cancer},

author = {Obón-Santacana M and Díez-Villanueva A and Alonso MH and Ibáñez-Sanz G and Guinó E and López A and Rodríguez-Alonso L and Mata A and García-Rodríguez A and Palomo AG and Molina AJ and Garcia M and Binefa G and Martín V and Moreno V},

doi = {10.1186/s12916-021-02134-x},

issn = {1741-7015},

year  = {2021},

date = {2021-11-01},

journal = {BMC Med},

volume = {19},

number = {1},

pages = {261},

abstract = {BACKGROUND: Different risk-based colorectal cancer (CRC) screening strategies, such as the use of polygenic risk scores (PRS), have been evaluated to improve effectiveness of these programs. However, few studies have previously assessed its usefulness in a fecal immunochemical test (FIT)-based screening study.nnMETHODS: A PRS of 133 single nucleotide polymorphisms was assessed for 3619 participants: population controls, screening controls, low-risk lesions (LRL), intermediate-risk (IRL), high-risk (HRL), CRC screening program cases, and clinically diagnosed CRC cases. The PRS was compared between the subset of cases (n = 648; IRL+HRL+CRC) and controls (n = 956; controls+LRL) recruited within a FIT-based screening program. Positive predictive values (PPV), negative predictive values (NPV), and the area under the receiver operating characteristic curve (aROC) were estimated using cross-validation.nnRESULTS: The overall PRS range was 110-156. PRS values increased along the CRC tumorigenesis pathway (Mann-Kendall P value 0.007). Within the screening subset, the PRS ranged 110-151 and was associated with higher risk-lesions and CRC risk (OR 1.92, 95% CI 1.22-3.03). The cross-validated aROC of the PRS for cases and controls was 0.56 (95% CI 0.53-0.59). Discrimination was equal when restricted to positive FIT (aROC 0.56), but lower among negative FIT (aROC 0.55). The overall PPV among positive FIT was 0.48. PPV were dependent on the number of risk alleles for positive FIT (PPVp10-p90 0.48-0.57).nnCONCLUSIONS: PRS plays an important role along the CRC tumorigenesis pathway; however, in practice, its utility to stratify the general population or as a second test after a FIT positive result is still doubtful. Currently, PRS is not able to safely stratify the general population since the improvement on PPV values is scarce.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34217412,

title = {The impact of the Covid-19 pandemic on breast cancer early detection and screening},

author = {Breast Screening Working Group (WG2) of the Covid-19 and Cancer Global Modelling Consortium and Figueroa JD and Gray E and Pashayan N and Deandrea S and Karch A and Vale DB and Elder K and Procopio P and van Ravesteyn NT and Mutabi M and Canfell K and Nickson C},

doi = {10.1016/j.ypmed.2021.106585},

issn = {1096-0260},

year  = {2021},

date = {2021-10-01},

journal = {Prev Med},

volume = {151},

pages = {106585},

abstract = {The COVID-19 pandemic affects mortality and morbidity, with disruptions expected to continue for some time, with access to timely cancer-related services a concern. For breast cancer, early detection and treatment is key to improved survival and longer-term quality of life. Health services generally have been strained and in many settings with population breast mammography screening, efforts to diagnose and treat breast cancers earlier have been paused or have had reduced capacity. The resulting delays to diagnosis and treatment may lead to more intensive treatment requirements and, potentially, increased mortality. Modelled evaluations can support responses to the pandemic by estimating short- and long-term outcomes for various scenarios. Multiple calibrated and validated models exist for breast cancer screening, and some have been applied in 2020 to estimate the impact of breast screening disruptions and compare options for recovery, in a range of international settings. On behalf of the Covid and Cancer Modelling Consortium (CCGMC) Working Group 2 (Breast Cancer), we summarize and provide examples of such in a range of settings internationally, and propose priorities for future modelling exercises. International expert collaborations from the CCGMC Working Group 2 (Breast Cancer) will conduct analyses and modelling studies needed to inform key stakeholders recovery efforts in order to mitigate the impact of the pandemic on early diagnosis and treatment of breast cancer.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34352591,

title = {Health and economic impact at a population level of both primary and secondary preventive lung cancer interventions: A model-based cost-effectiveness analysis},

author = {Diaz M and Garcia M and Vidal C and Santiago A and Gnutti G and Gómez D and Trapero-Bertran M and Fu M and Lung Cancer Prevention LUCAPREV research group},

doi = {10.1016/j.lungcan.2021.06.027},

issn = {1872-8332},

year  = {2021},

date = {2021-09-01},

journal = {Lung Cancer},

volume = {159},

pages = {153--161},

abstract = {OBJECTIVES: Robust economic evaluations are needed to identify efficient strategies for lung cancer prevention that combine brief and intensive smoking cessation intervention programmes with screening using low-dose computed tomography (LDCT) at different ages, frequencies, and coverages. We aimed to assess the cost-effectiveness of smoking cessation approaches combined with lung cancer screening in the European context at a population level from a societal perspective.nnMATERIALS AND METHODS: A microsimulation model that describes the natural history of lung cancer and incorporates several prevention strategies was developed. Discounted lifetime QALYs and costs at a rate of 3% were used to calculate incremental cost-effectiveness ratios, defined as additional costs in 2017 Euros per QALY gained.nnRESULTS: Smoking cessation interventions reduce the incidence of lung cancer by 8%-46% and are consistently more effective and cost-effective when starting at younger ages. Screening reduces lung cancer mortality by 1%-24% and is generally less effective and more costly than smoking cessation interventions. The most cost-effective strategy would be to implement intensive smoking cessation interventions at ages 35, 40 and 45, combined with screening every three years between the ages of 55 and 65.nnCONCLUSIONS: Combining smoking cessation interventions with LDCT screening is a very attractive prevention strategy that substantially diminishes the burden of lung cancer. These combined prevention strategies, especially when providing several intensive interventions for smoking cessation at early ages, are more cost-effective than both approaches separately and allow for a more intensified LDCT without losing efficiency.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33409776,

title = {Breast density, benign breast disease, and risk of breast cancer over time},

author = {Román M and Louro J and Posso M and Alcántara R and Peñalva L and Sala M and Del Riego J and Prieto M and Vidal C and Sánchez M and Bargalló X and Tusquets I and Castells X},

doi = {10.1007/s00330-020-07490-5},

issn = {1432-1084},

year  = {2021},

date = {2021-07-01},

journal = {Eur Radiol},

volume = {31},

number = {7},

pages = {4839--4847},

abstract = {OBJECTIVES: Assessing the combined effect of mammographic density and benign breast disease is of utmost importance to design personalized screening strategies.nnMETHODS: We analyzed individual-level data from 294,943 women aged 50-69 years with at least one mammographic screening participation in any of four areas of the Spanish Breast Cancer Screening Program from 1995 to 2015, and followed up until 2017. We used partly conditional Cox models to assess the association between benign breast disease, breast density, and the risk of breast cancer.nnRESULTS: During a median follow-up of 8.0 years, 3697 (1.25%) women had a breast cancer diagnosis and 5941 (2.01%) had a benign breast disease. More than half of screened women had scattered fibroglandular density (55.0%). The risk of breast cancer independently increased with the presence of benign breast disease and with the increase in breast density (p for interaction = 0.84). Women with benign breast disease and extremely dense breasts had a threefold elevated risk of breast cancer compared with those with scattered fibroglandular density and without benign breast disease (hazard ratio [HR] = 3.07; 95%CI = 2.01-4.68). Heterogeneous density and benign breast disease was associated with nearly a 2.5 elevated risk (HR = 2.48; 95%CI = 1.66-3.70). Those with extremely dense breast without a benign breast disease had a 2.27 increased risk (95%CI = 2.07-2.49).nnCONCLUSIONS: Women with benign breast disease had an elevated risk for over 15 years independently of their breast density category. Women with benign breast disease and dense breasts are at high risk for future breast cancer.nnKEY POINTS: • Benign breast disease and breast density were independently associated with breast cancer. • Women with benign breast disease had an elevated risk for up to 15 years independently of their mammographic density category.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33422578,

title = {Role of community pharmacies in a population-based colorectal cancer screening program},

author = {Vives N and Milà N and Binefa G and Travier N and Farre A and Vidal C and Sattari M and Bagaria G and Garcia M},

doi = {10.1016/j.ypmed.2021.106420},

issn = {1096-0260},

year  = {2021},

date = {2021-04-01},

journal = {Prev Med},

volume = {145},

pages = {106420},

abstract = {In Catalonia (Spain), population-based colorectal cancer (CRC) screening offers biennial fecal occult blood testing to men and women aged 50-69 years old. The program is organized in screening hubs, most of which use a pharmacy-based model to distribute and collect fecal immunochemical test (FIT) kits The comprehensive evaluation of CRC screening programs, which include the role and implications of pharmacy involvement, is essential to ensure program quality and identify areas for further improvement. The present study aimed to assess the adherence of community pharmacies to the CRC screening program and to analyze data on FIT kit distribution and collection in the Metropolitan area of Barcelona (Catalonia, Spain). Time to FIT completion was assessed by Kaplan-Meier estimation, and with the log-rank test. A Cox regression model was used to adjust for other variables associated with the completion of FIT such as sex, age, deprivation score index and previous screening behavior. Overall, 82.4% of pharmacies adhered with CRC screening program. Out of 82,902 FIT kits distributed to screening invitees 77,524 completed FIT kits were returned to pharmacies (93.5%) with a participation of 39.8% among the 193,766 invitees. From those who completed a FIT, the median time to return the kit was 3 days. FIT completion time was significantly lower among women, older age, high deprivation score index and previous CRC screening (p < 0.005). Our findings highlight the large involvement of community pharmacists with CRC screening program as well as a high quality in the process of FIT distribution and collection.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33809520,

title = {Future Prospects of Colorectal Cancer Screening: Characterizing Interval Cancers},

author = {Ibáñez-Sanz G and Sanz-Pamplona R and Garcia M and On Behalf Of The Msic-Sc Research Group },

doi = {10.3390/cancers13061328},

issn = {2072-6694},

year  = {2021},

date = {2021-03-01},

journal = {Cancers (Basel)},

volume = {13},

number = {6},

abstract = {Tumors that are not detected by screening tests are known as interval cancers and are diagnosed clinically after a negative result in the screening episode but before the next screening invitation. Clinical characteristics associated with interval colorectal cancers have been studied, but few molecular data are available that describe interval colorectal cancers. A better understanding of the clinical and biological characteristics associated with interval colorectal cancer may provide new insights into how to prevent this disease more effectively. This review aimed to summarize the current literature concerning interval colorectal cancer and its epidemiological, clinical, and molecular features.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33358209,

title = {Risk of breast cancer two years after a benign biopsy depends on the mammographic feature prompting recall},

author = {Vernet-Tomás M and Louro J and Román M and Saladié F and Posso M and Prieto M and Vázquez I and Baré M and Peñalva L and Vidal C and Bargalló X and Sánchez M and Ferrer J and A Espinàs J and Quintana MJ and Rodríguez-Arana A and Castells X and BELE study group},

doi = {10.1016/j.maturitas.2020.10.024},

issn = {1873-4111},

year  = {2021},

date = {2021-02-01},

journal = {Maturitas},

volume = {144},

pages = {53--59},

abstract = {OBJECTIVE: We aimed to explore whether the type of mammographic feature prompting a false-positive recall (FPR) during mammography screening influences the risk and timing of breast cancer diagnosis, particularly if assessed with invasive procedures.nnSTUDY DESIGN: We included information on women screened and recalled for further assessment in Spain between 1994 and 2015, with follow-up until 2017, categorizing FPRs by the assessment (noninvasive or invasive) and mammographic feature prompting the recall.nnMAIN OUTCOME MEASURES: Breast cancer rates in the first two years after FPR (first period) and after two years (second period).nnRESULTS: The study included 99,825 women with FPRs. In both periods, the breast cancer rate was higher in the invasive assessment group than in the noninvasive group (first period 12 ‰ vs 1.9 ‰, p < 0.001; second period 4.4‰ vs 3.1‰, p < 0.001). During the first period, the invasive assessment group showed diverse breast cancer rates for each type of mammographic feature, with a higher rate for asymmetric density (31.9‰). When the second period was compared with the first, the breast cancer rate decreased in the invasive assessment group (from 12‰ to 4.4‰, p < 0.001) and increased in the noninvasive assessment group (from 1.9‰ to 3.1‰, p < 0.001).nnCONCLUSION: In the context of mammography screening, the risk of breast cancer diagnosis during the first two years after FPR was particularly high for women undergoing invasive assessment; importantly, the risk was modified by type of mammographic feature prompting the recall. This information could help to individualize follow-up after exclusion of malignancy.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33496270,

title = {[Inequalities in access to cancer screening programmes in Spain and how to reduce them: data from 2013 and 2020.]},

author = {Molina-Barceló A and Moreno Salas J and Peiró-Pérez R and Arroyo G and Ibáñez Cabanell J and Vanaclocha Espí M and Binefa G and García M and Salas Trejo D},

issn = {2173-9110},

year  = {2021},

date = {2021-01-01},

journal = {Rev Esp Salud Publica},

volume = {95},

abstract = {OBJECTIVE: The European Commission recommends ensuring equity in cancer screening. The aim of this study was to find out if there were inequalities in access to cancer screening programmes in Spain.nnMETHODS: A transversal study was carried out by means of a survey addressed to the people responsible for breast, colorectal (CRC) and cervical cancer screening programmes in the 19 Autonomous Communities (AC) of Spain in 2013 and 2020. Information was collected on organizational characteristics, inequalities in access and interventions to reduce them. A descriptive analysis was made by AC and time period, by calculating frequencies and percentages, depending on the type of programme (breast, CRC and cervix).nnRESULTS: In 2013, 14 ACs participated for the breast programme, 8 for the CRC and 7 for the cervical programme; and in 2020, 14, 13 and 11 ACs respectively. All breast programmes were population-based in both periods (14/14 in 2013 and 14/14 in 2020), as well as CRC ones (8/8 in 2013 and 13/13 in 2020), with an increase in cervical cancer programmes (0/7 en 2013 y 6/11 en 2020). In both periods, social groups not included in the target population and groups that were less involved were identified, with differences according to the type of programme. A total of 53 interventions were carried out to reduce inequalities in access (27 in breast, 22 in RCC and 4 in cervical), 66% of them aimed at specific social groups (35/53).nnCONCLUSIONS: Inequalities in access to cancer screening programmes in Spain are identified, as well as interventions to reduce them.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33481914,

title = {Text messaging as a tool to improve cancer screening programs (M-TICS Study): A randomized controlled trial protocol},

author = {Vives N and Farre A and Ibáñez-Sanz G and Vidal C and Binefa G and Milà N and Pérez-Lacasta MJ and Travier N and Benito L and Espinàs JA and Bagaria G and Garcia M},

doi = {10.1371/journal.pone.0245806},

issn = {1932-6203},

year  = {2021},

date = {2021-01-01},

journal = {PLoS One},

volume = {16},

number = {1},

pages = {e0245806},

abstract = {BACKGROUND: Short message service (SMS) based interventions are widely used in healthcare and have shown promising results to improve cancer screening programs. However, more research is still needed to implement SMS in the screening process. We present a study protocol to assess the impact on health and economics of three targeted SMS-based interventions in population-based cancer screening programs.nnMETHODS/DESIGN: The M-TICs study is a randomized controlled trial with a formal process evaluation. Participants aged 50-69 years identified as eligible from the colorectal cancer (CRC) and breast cancer (BC) screening program of the Catalan Institute of Oncology (Catalonia, Spain) will be randomly assigned to receive standard invitation procedure (control group) or SMS-based intervention to promote participation. Two interventions will be conducted in the CRC screening program: 1) Screening invitation reminder: Those who do not participate in the CRC screening within 6 weeks of invite will receive a reminder (SMS or letter); 2) Reminder to complete and return fecal immunochemical test (FIT) kit: SMS reminder versus no intervention to individuals who have picked up a FIT kit at the pharmacy and they have not returned it after 14 days. The third intervention will be performed in the BC screening program. Women who had been screened previously will receive an SMS invitation or a letter invitation to participate in the screening. As a primary objective we will assess the impact on participation for each intervention. The secondary objectives will be to analyze the cost-effectiveness of the interventions and to assess participants' perceptions.nnEXPECTED RESULTS: The results from this randomized controlled trial will provide important empirical evidence for the use of mobile phone technology as a tool for improving population-based cancer screening programs. These results may influence the cancer screening invitation procedure in future routine practice.nnTRIAL REGISTRATION: Registry: NCT04343950 (04/09/2020); clinicaltrials.gov.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid32173050,

title = {[Informed choice in breast cancer screening: the role of education]},

author = {Pons-Rodríguez A and Martínez-Alonso M and Perestelo-Pérez L and Garcia M and Sala M and Rué M and en nombre del grupo InforMa and El grupo InforMa está formado por},

doi = {10.1016/j.gaceta.2020.01.002},

issn = {1578-1283},

year  = {2021},

date = {2021-01-01},

journal = {Gac Sanit},

volume = {35},

number = {3},

pages = {243--249},

abstract = {OBJECTIVE: To evaluate the effect of receiving information about the benefits and harms of breast cancer screening in informed choice, according to educational level.nnMETHOD: Secondary analysis of a randomized, controlled study, in four screening programs, in Catalonia and the Canary Islands (Spain). We analyzed 400 women who were going to be invited to participate for the first time. The intervention group received a decision aid that showed the benefits and harms of screening. The control group received a standard brochure that recommended participating in the screening program. Educational level was grouped into two categories, low and high. The primary outcome was informed choice defined as adequate knowledge and consistency between attitudes and intentions.nnRESULTS: The intervention produced a greater increase in knowledge in women with a high educational level compared to those with a lower educational level. Among women who received the intervention, informed choice was almost three times higher in those with a high educational level (27% versus 11%). No differences were observed between educational levels in decisional conflict, confidence in the decision, anxiety and worry about breast cancer, in the intervention and control groups.nnCONCLUSIONS: A decision aid for breast cancer screening had much more impact on informed choice among women with a high educational level. In women with low educational level, the attitude towards screening improved and there was an increase in the intention to be screened.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33159805,

title = {Proton-pump inhibitors are associated with a high false-positivity rate in faecal immunochemical testing},

author = {Ibáñez-Sanz G and Milà N and de la Peña-Negro LC and Garcia M and Vidal C and Rodríguez-Alonso L and Binefa G and Rodríguez-Moranta F and Moreno V},

doi = {10.1007/s00535-020-01738-z},

issn = {1435-5922},

year  = {2021},

date = {2021-01-01},

journal = {J Gastroenterol},

volume = {56},

number = {1},

pages = {42--53},

abstract = {BACKGROUND: False-positivity rates in faecal immunochemical test (FIT) can be affected by drug exposure. We aimed to assess the association between proton pump inhibitors (PPI) consumption and false positive (FP) results in a colorectal cancer (CRC) screening programme using electronic prescription records.nnMETHODS: A retrospective cohort study within a population-based screening program for CRC from 2010 to 2016 was performed. Participants with a conclusive FIT result and with prescription electronic data were included. An FP result was defined as having a positive FIT (≥ 20 µg haemoglobin/g faeces) and a follow-up colonoscopy without intermediate or high-risk lesions or CRC. Screening data were anonymously linked to the public data analysis program for health research and innovation (PADRIS) database that recorded patient diseases history and reimbursed medication. PPI exposure was defined as having retrieved at least one dispensation of PPI three months prior to the FIT.nnRESULTS: A total of 89,199 tests (of 46,783 participants) were analysed, 4824 (5.4%) tested positive and the proportion of FP was 53.5%. Overall, 17,544 participants (19.7%) were PPI users prior to FIT performance. PPI exposure increased the probability of obtaining an FP FIT result from 50.4 to 63.3% (adjusted OR 1.39; 95% CI 1.18-1.65). Nonsteroidal anti-inflammatory drugs, acetylsalicylic acid, antibiotics, and laxatives were also associated with an FP result. The effect of PPI was independent and showed a synergistic interaction with nonsteroidal anti-inflammatory drugs.nnCONCLUSION: PPIs increase FIT positivity at the expense of FP results. The recommendation to avoid their use before FIT performance could reduce up to 3% of colonoscopies and 9% of FP results.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid32151468,

title = {Outreach HIV testing using oral fluid and online consultation of the results: Pilot intervention in Catalonia},

author = {Agustí C and Muñoz R and González V and Villegas L and Fibla J and Meroño M and Capitán A and Fernàndez-López L and Platteau T and Casabona J},

doi = {10.1016/j.eimc.2020.01.020},

issn = {2529-993X},

year  = {2021},

date = {2021-01-01},

journal = {Enferm Infecc Microbiol Clin (Engl Ed)},

volume = {39},

number = {1},

pages = {3--8},

abstract = {INTRODUCTION: The aim of the intervention was to describe the feasibility and cost-effectiveness of offering HIV testing in outreach interventions and subsequent consultation of the results through a secure web page.nnMETHODS: The HIV test was offered "in situ" to men who have sex with men (MSM), migrant sex workers and trans women recruited in places of leisure and sex. Four collaborating NGOs recruited the participants and assisted them to register on the study website (www.swab2know.eu) through a tablet or the smartphone of the same participant. The samples were sent to the reference laboratory and the results were published on the website.nnRESULTS: 834 participants (612 MSMs, 203 women sex workers and 19 trans women) were recruited. In total 22 reagent results (2.6%) were detected: 21 among MSMs (3.4%) and 1 in a trans women (5.3%). While 82.6% of MSMs consulted their outcome, only 39.9% and 26.3% of women sex workers and trans women respectively consulted their outcome CONCLUSIONS: Providing self-sampling in outreach activities, dispatch and analysis in a reference laboratory as well as online communication of test results is feasible. A high proportion of participants with a HIV reactive result were detected among MSMs and trans women.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34191813,

title = {Positive impact of a faecal-based screening programme on colorectal cancer mortality risk},

author = {Ibáñez-Sanz G and Milà N and Vidal C and Rocamora J and Moreno V and Sanz-Pamplona R and Garcia M and MSIC-SC research group},

doi = {10.1371/journal.pone.0253369},

issn = {1932-6203},

year  = {2021},

date = {2021-01-01},

journal = {PLoS One},

volume = {16},

number = {6},

pages = {e0253369},

abstract = {INTRODUCTION: The effectiveness of colorectal cancer (CRC) screening programs is directly related to participation and the number of interval CRCs. The objective was to analyse specific-mortality in a cohort of individuals invited to a CRC screening program according to type of CRC diagnosis (screen-detected cancers, interval cancers, and cancers among the non-uptake group).nnMATERIAL AND METHODS: Retrospective cohort that included invitees aged 50-69 years of a CRC screening program (target population of 85,000 people) in Catalonia (Spain) from 2000-2015 with mortality follow-up until 2020. A screen-detected CRC was a cancer diagnosed after a positive faecal occult blood test (guaiac or immunochemical); an interval cancer was a cancer diagnosed after a negative test result and before the next invitation to the program (≤24 months); a non-uptake cancer was a cancer in subjects who declined screening.nnRESULTS: A total of 624 people were diagnosed with CRC (n = 265 screen-detected, n = 103 interval cancers, n = 256 non-uptake). In the multivariate analysis, we observed a 74% increase in mortality rate in the group with interval CRC compared to screen-detected CRC adjusted for age, sex, location and stage (HR: 1.74%, 95% CI:1.08-2.82, P = 0.02). These differences were found even when we restricted for advanced-cancers participants. In the stratified analysis for type of faecal occult blood test, a lower mortality rate was only observed among FIT screen-detected CRCs.nnCONCLUSION: CRC screening with the FIT was associated with a significant reduction in CRC mortality.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33755692,

title = {Developing and validating an individualized breast cancer risk prediction model for women attending breast cancer screening},

author = {Louro J and Román M and Posso M and Vázquez I and Saladié F and Rodriguez-Arana A and Quintana MJ and Domingo L and Baré M and Marcos-Gragera R and Vernet-Tomas M and Sala M and Castells X and BELE and IRIS Study Groups},

doi = {10.1371/journal.pone.0248930},

issn = {1932-6203},

year  = {2021},

date = {2021-01-01},

journal = {PLoS One},

volume = {16},

number = {3},

pages = {e0248930},

abstract = {BACKGROUND: Several studies have proposed personalized strategies based on women's individual breast cancer risk to improve the effectiveness of breast cancer screening. We designed and internally validated an individualized risk prediction model for women eligible for mammography screening.nnMETHODS: Retrospective cohort study of 121,969 women aged 50 to 69 years, screened at the long-standing population-based screening program in Spain between 1995 and 2015 and followed up until 2017. We used partly conditional Cox proportional hazards regression to estimate the adjusted hazard ratios (aHR) and individual risks for age, family history of breast cancer, previous benign breast disease, and previous mammographic features. We internally validated our model with the expected-to-observed ratio and the area under the receiver operating characteristic curve.nnRESULTS: During a mean follow-up of 7.5 years, 2,058 women were diagnosed with breast cancer. All three risk factors were strongly associated with breast cancer risk, with the highest risk being found among women with family history of breast cancer (aHR: 1.67), a proliferative benign breast disease (aHR: 3.02) and previous calcifications (aHR: 2.52). The model was well calibrated overall (expected-to-observed ratio ranging from 0.99 at 2 years to 1.02 at 20 years) but slightly overestimated the risk in women with proliferative benign breast disease. The area under the receiver operating characteristic curve ranged from 58.7% to 64.7%, depending of the time horizon selected.nnCONCLUSIONS: We developed a risk prediction model to estimate the short- and long-term risk of breast cancer in women eligible for mammography screening using information routinely reported at screening participation. The model could help to guiding individualized screening strategies aimed at improving the risk-benefit balance of mammography screening programs.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}