The validation of a simulation model incorporating radiation risk for mammography breast cancer screening in women with a hereditary-increased breast cancer risk

Population-based genomic screening is at the forefront of a new approach to disease prevention. Yet the lack of diversity in genome wide association studies and ongoing debates about the appropriate use of racial and ethnic categories in genomics raise key questions about the translation of genomic knowledge into clinical practice. This article reports on an ethnographic study of a large pragmatic clinical trial of breast cancer screening called WISDOM (Women Informed to Screen Depending On Measures of Risk). Our ethnography illuminates the challenges of using race or ethnicity as a risk factor in the implementation of precision breast cancer risk assessment. Our analysis provides critical insights into how categories of race, ethnicity and ancestry are being deployed in the production of genomic knowledge and medical practice, and key challenges in the development and implementation of novel Polygenic Risk Scores in the research and clinical applications of this emerging science. Specifically, we show how the conflation of social and biological categories of difference can influence risk prediction for individuals who exist at the boundaries of these categories, affecting the perceptions and practices of scientists, clinicians, and research participants themselves. Our research highlights the potential harms of practicing genomic medicine using under-theorized and ambiguous categories of race, ethnicity, and ancestry, particularly in an adaptive, pragmatic trial where research findings are applied in the clinic as they emerge. We contribute to the expanding literature on categories of difference in post-genomic science by closely examining the implementation of a large breast cancer screening study that aims to personalize breast cancer risk using both common and rare genomic markers.

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Online self-test identifies women at high familial breast cancer risk in population-based breast cancer screening without inducing anxiety or distress

European Journal of Cancer ◽

10.1016/j.ejca.2017.03.014 ◽

2017 ◽

Vol 78 ◽

pp. 45-52 ◽

Cited By ~ 6

Author(s):

A. van Erkelens ◽

A.S. Sie ◽

P. Manders ◽

A. Visser ◽

L.E. Duijm ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Breast Cancer Screening ◽

Familial Breast Cancer ◽

Population Based ◽

Self Test ◽

Familial Breast Cancer Risk

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Assessment of Breast Cancer Risk and Belief in Breast Cancer Screening Among the Primary Healthcare Nurses

Journal of Cancer Education ◽

10.1007/s13187-015-0977-y ◽

2016 ◽

Vol 31 (3) ◽

pp. 575-581 ◽

Cited By ~ 1

Author(s):

Fatma Başalan İz ◽

Adile Tümer

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Breast Cancer Screening ◽

Primary Healthcare

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Evaluating the frequency of breast cancer risk factors in women referred to mammography center for breast cancer screening: A report from south part of Iran

Journal of Cancer Policy ◽

10.1016/j.jcpo.2018.04.004 ◽

2018 ◽

Vol 16 ◽

pp. 33-38 ◽

Cited By ~ 1

Author(s):

Zareh rahime ◽

Wrya Parwaie ◽

Bagher Farhood ◽

Mahdieh Afkhami Ardekani ◽

Hossein Safari

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Cancer Screening ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Breast Cancer Screening ◽

Cancer Risk Factors ◽

Breast Cancer Risk Factors

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Dutch women’s intended participation in a risk-based breast cancer screening and prevention programme: a survey study identifying preferences, facilitators and barriers

BMC Cancer ◽

10.1186/s12885-020-07464-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Linda Rainey ◽

Daniëlle van der Waal ◽

Mireille J. M. Broeders

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Breast Cancer Screening ◽

Lifestyle Changes ◽

Survey Study ◽

Prevention Programme ◽

Cancer Screening And Prevention ◽

Screening And Prevention

Abstract Background Risk-based breast cancer screening may improve the benefit-harm ratio of screening by tailoring policy to a woman’s personal breast cancer risk. This study aims to explore Dutch women’s preferences regarding the organisation and implementation of a risk-based breast cancer screening and prevention programme, identifying potential barriers and facilitators to uptake. Methods A total of 5110 participants in the Dutch Personalised RISk-based MAmmography screening (PRISMA) study were invited, of whom 942 completed a two-part web-based survey. The first part contained questions about personal characteristics; for the second part, women were randomly assigned to one of four hypothetical breast cancer risk scenarios (i.e. low, average, moderate, or high) with subsequent tailored screening and prevention advice. Descriptive statistics are used to present women’s organisational preferences. Univariable and multivariable logistic regression analyses were performed using seven proxy measures for acceptability of risk-based screening (e.g., interest in risk) and risk-based prevention (e.g., willingness to change diet). Results Interest in breast cancer risk was high (80.3%). Higher assigned risk scenario was most consistently associated with acceptance of tailored screening and prevention recommendations. Increased acceptance of lifestyle changes was additionally associated with higher education. Having a first degree family history of breast cancer decreased women’s motivation to participate in preventative lifestyle measures. Acceptability of medication was associated with a woman’s general beliefs about the (over)use and benefit-harm balance of medication. Conclusions Dutch women generally appear in favour of receiving their breast cancer risk estimate with subsequent tailored screening and prevention recommendations. However, women’s level of acceptance depends on their assigned risk category. Offering tailored screening and prevention recommendations to low-risk women will be most challenging. Educating women on the benefits and harms of all risk-based screening and prevention strategies is key to acceptability and informed decision-making.

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Prevalence of Known Risk Factors of Breast Cancer and Breast Cancer Screening Practices Among Women in Thiruvananthapuram, Kerala, India

Journal of Global Oncology ◽

10.1200/jgo.18.48200 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 23s-23s

Author(s):

S. John ◽

R. Jose ◽

V.A. Dhanuja ◽

J.C. Haran ◽

P. Augustine

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Cancer Screening ◽

High Risk ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Breast Cancer Screening ◽

Risk Calculator ◽

Screening Practices ◽

Study Participants

Background: Breast cancer rates are rising both in the developed and the developing world, probably due to increase in life expectancy, increasing urbanization and adoption of western lifestyles. Incidence of breast cancer is reported to be increasing in India and it has become the most common cancer among women. Kerala and its capital city Thiruvananthapuram are also following the same pattern. Early detection and treatment of breast cancer is highly beneficial as it leads to increased survival rates and better quality of life to the patient. By identifying the risk factors and through regular and proper screening practices, we can detect the high risk population for this disease and contribute to its prevention and early treatment. Aim: 1. To study the prevalence of known risk factors of breast cancer among women aged 20 years and above in Thiruvananthapuram, Kerala, India. 2. To describe the breast cancer screening practices prevalent in the study population and to find out the proportion of high risk individuals using breast cancer risk calculator. Methods: A community based cross sectional survey was conducted among 2000 women hailing from Thiruvananthapuram. General population was invited through mass media to attend breast cancer screening camps. 2000 women aged more than 20 years who attended the camps and gave informed consent were included in the study. Data were collected from 40 participants each from 50 camps out of a total of 150 screening camps. A semi structured pro forma was used to collect the data regarding the sociodemographic profile, the various known risk factors of breast cancer according to research literature and breast cancer screening methods undergone. Descriptive statistics was done using SPSS version 16. Results are expressed in proportions with 95% confidence interval, wherever appropriate. Results: The mean age of the study population was 45.67 years. Majority of the women 82.5% had never undergone any sort of breast cancer screening. Clinical breast examination alone was undergone by 9.8%. Breast cancer risk calculator showed that 65% of the women screened had normal risk, 22.2% had moderate risk and 12.9% had high risk. Conclusion: Increased prevalence of major known risk factors of breast cancer like positive family history, low breast feeding duration, late age at menopause, are found. Also the prevalence of modifiable risk factors like obesity and low physical activity are high. Majority of the study participants have never undergone any breast cancer screening. Breast cancer risk calculator showed a fairly high prevalence of study participants in high risk and moderate risk category and therefore women need to be motivated to undergo regular screening.

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