The Applicability of the Gail Model in Iranian Population

Abstract

Introduction: Gail model is one of the most important models for the evaluation of breast cancer risk between US white females. According to genetic diversity, there is a possibility of affecting the efficiency of the Gail model in risk assessment of breast cancer among Iranian populations. In this study, the Gail model efficiency in specifying the risk of breast cancer in Iranian population was evaluated. Methods: This was a case-control study. The case group was formed of the referrals to Breast Cancer Research Center, Academic Center for Education Culture and Research (ACECR), who were affected by different types of aggressive cancer. Results: A total of 416 patients with breast cancer and the same number in the control group were considered during the study. There were no meaningful statistical differences in age at menarche, age at first live birth, and nulliparous women between case and control groups. The average of five-year risk of breast cancer in the case and control groups had no statistically significant difference. Chemoprevention was only eligible for 7.2% of the patients based on 1.67% five-year risk. In addition, there was no statistically meaningful difference between comparative risk and breast cancer risk in a lifetime. Conclusions: The low risks estimated by the Gail model among patients with breast cancer as well as the absence of meaningful statistical difference in the estimated risks by this model between the case and control groups showed that the Gail model had insufficient efficiency in determining breast cancer risk in the Iranian society.

Use and Applicability of the Gail Model to Calculate Breast Cancer Risk: A Scoping Review

“…In India, the studies conducted by Challa et al, (2013), andThomas et al, (2016), both case-control, underestimated the risk within five years of developing breast cancer. The same occurred in Iran in the studies by Omranipour et al, (2015) and Farahmand et al, (2017), which underestimated the risk in women with the disease and found no significant between-group difference in the risk factors evaluated by the model (Table 2).…”

Developing a core risk factors set for assessment of breast cancer risk in Iranian females: A qualitative Delphi consensus.

“…Today, there are different models for identifying the risk of breast cancer in women, of which the Gail model is the best known (5). The well-known model of Gail in white American women who have access to mammography is considered as an effective tool to identify the risk of breast cancer, but the use of this model in Iranian women is not very effective because, this model, overestimates the risk of BC in Iranian women (5)(6)(7)(8)(9). There are variations in the relative identi ed risk of individual breast cancer, and these variations may arise from differences in race, taking into account epidemiological diversity and risk factors for breast cancer in populations such as Iranian women (10,11).…”