Towards implementation of comprehensive breast cancer risk prediction tools in health care for personalised prevention

Moorthie, Sowmiya; Villiers, Chantal Babb de; Burton, Hilary; Kroese, Mark; Antoniou, Antonis C.; Bhattacharjee, Proteeti; García‐Closas, Montserrat; Hall, Per; Schmidt, Marjanka K.

doi:10.1016/j.ypmed.2022.107075

Cited by 6 publications

(4 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent qualitative synthesis identified that this is one of the most important issues to consider in order to implement personalized screening [ 62 ]. It is essential to emphasize further training of HCPs to assess, interpret and communicate risk [ 63 ]. Lapointe et al propose that the training programs of future professionals should include more content on genetic issues and continuous professional training to address these knowledge gaps [ 64 ]; along with the generation of clinical guidelines and protocols for the implementation of personalized breast cancer screening [ 65 ].…”

Section: Discussionmentioning

confidence: 99%

“For and against” factors influencing participation in personalized breast cancer screening programs: a qualitative systematic review until March 2022

Laza,

Niño de Guzmán,

Gea

et al. 2024

Arch Public Health

View full text Add to dashboard Cite

Background Personalized breast cancer screening is a novel strategy that estimates individual risk based on age, breast density, family history of breast cancer, personal history of benign breast lesions, and polygenic risk. Its goal is to propose personalized early detection recommendations for women in the target population based on their individual risk. Our aim was to synthesize the factors that influence women’s decision to participate in personalized breast cancer screening, from the perspective of women and health care professionals. Methods Systematic review of qualitative evidence on factors influencing participation in personalized Breast Cancer Screening. We searched in Medline, Web of science, Scopus, EMBASE, CINAHL and PsycINFO for qualitative and mixed methods studies published up to March 2022. Two reviewers conducted study selection and extracted main findings. We applied the best-fit framework synthesis and adopted the Multilevel influences on the cancer care continuum model for analysis. After organizing initial codes into the seven levels of the selected model, we followed thematic analysis and developed descriptive and analytical themes. We assessed the methodological quality with the Critical Appraisal Skills Program tool. Results We identified 18 studies published between 2017 and 2022, conducted in developed countries. Nine studies were focused on women (n = 478) and in four studies women had participated in a personalized screening program. Nine studies focused in health care professionals (n = 162) and were conducted in primary care and breast cancer screening program settings. Factors influencing women’s decision to participate relate to the women themselves, the type of program (personalized breast cancer screening) and perspective of health care professionals. Factors that determined women participation included persistent beliefs and insufficient knowledge about breast cancer and personalized screening, variable psychological reactions, and negative attitudes towards breast cancer risk estimates. Other factors against participation were insufficient health care professionals knowledge on genetics related to breast cancer and personalized screening process. The factors that were favourable included the women’s perceived benefits for themselves and the positive impact on health systems. Conclusion We identified the main factors influencing women’s decisions to participate in personalized breast cancer screening. Factors related to women, were the most relevant negative factors. A future implementation requires improving health literacy for women and health care professionals, as well as raising awareness of the strategy in society.

show abstract

Section: Discussionmentioning

confidence: 99%

“For and against” factors influencing participation in personalized breast cancer screening programs: a qualitative systematic review until March 2022

Laza,

Niño de Guzmán,

Gea

et al. 2024

Arch Public Health

View full text Add to dashboard Cite

show abstract

“…The notes document was used to produce descriptive themes based on the key topics that attendees discussed in groups and focussed on in the plenary session. All points raised in the meeting were captured within the descriptive themes, an approach which has been previously used in articles outlining agenda setting meetings and workshops [34,35]. The results were initially structured in a separate document (Table 1) using the ten indicative uncertainties as sub-headings and involved iterations of combining these or adding new headings to produce the five descriptive themes.…”

Section: Discussionmentioning

confidence: 99%

Implementing Risk-Stratified Breast Screening in England: An Agenda Setting Meeting

McWilliams

Evans²,

Payne³

et al. 2022

Cancers

View full text Add to dashboard Cite

It is now possible to accurately assess breast cancer risk at routine NHS Breast Screening Programme (NHSBSP) appointments, provide risk feedback and offer risk management strategies to women at higher risk. These strategies include National Institute for Health and Care Excellence (NICE) approved additional breast screening and risk-reducing medication. However, the NHSBSP invites nearly all women three-yearly, regardless of risk. In March 2022, a one-day agenda setting meeting took place in Manchester to discuss the feasibility and desirability of implementation of risk-stratified screening in the NHSBSP. Fifty-eight individuals participated (38 face-to-face, 20 virtual) with relevant expertise from academic, clinical and/or policy-making perspectives. Key findings were presented from the PROCAS2 NIHR programme grant regarding feasibility of risk-stratified screening in the NHSBSP. Participants discussed key uncertainties in seven groups, followed by a plenary session. Discussions were audio-recorded and thematically analysed to produce descriptive themes. Five themes were developed: (i) risk and health economic modelling; (ii) health inequalities and communication with women; (iii); extending screening intervals for low-risk women; (iv) integration with existing NHSBSP; and (v) potential new service models. Most attendees expected some form of risk-stratified breast screening to be implemented in England and collectively identified key issues to be resolved to facilitate this.

show abstract

“…Many of these are also risk factors for cancer 17 . Risk prediction models that incorporate these types of risk factors are used in clinical settings for personalized prevention in cardiovascular health and for certain cancers 18 – 21 . Examples include the well-known Framingham risk score, which was the first CVD risk prediction tool, and the Gail model/Breast Cancer Risk Assessment Tool for the prediction of a woman’s risk of developing invasive breast cancer 18 – 23 .…”

Section: Introductionmentioning

confidence: 99%

“…Risk prediction models that incorporate these types of risk factors are used in clinical settings for personalized prevention in cardiovascular health and for certain cancers 18 – 21 . Examples include the well-known Framingham risk score, which was the first CVD risk prediction tool, and the Gail model/Breast Cancer Risk Assessment Tool for the prediction of a woman’s risk of developing invasive breast cancer 18 – 23 . These tools can be incorporated into a comprehensive radiation risk assessment strategy for space crews that extends modeling capability to include informed consent and medical management of space radiation-related health risks 15 , 24 .…”

Section: Introductionmentioning

confidence: 99%

Considering clonal hematopoiesis of indeterminate potential in space radiation risk analysis for hematologic cancers and cardiovascular disease

Werneth,

Patel,

Thompson

et al. 2024

Commun Med

View full text Add to dashboard Cite

Background Expanding human presence in space through long-duration exploration missions and commercial space operations warrants improvements in approaches for quantifying crew space radiation health risks. Currently, risk assessment models for radiogenic cancer and cardiovascular disease consider age, sex, and tobacco use, but do not incorporate other modifiable (e.g., body weight, physical activity, diet, environment) and non-modifiable individual risk factors (e.g., genetics, medical history, race/ethnicity, family history) that may greatly influence crew health both in-mission and long-term. For example, clonal hematopoiesis of indeterminate potential (CHIP) is a relatively common age-related condition that is an emerging risk factor for a variety of diseases including cardiovascular disease and cancer. CHIP carrier status may therefore exacerbate health risks associated with space radiation exposure. Methods In the present study, published CHIP hazard ratios were used to modify background hazard rates for coronary heart disease, stroke, and hematologic cancers in the National Aeronautics and Space Administration space radiation risk assessment model. The risk of radiation exposure-induced death for these endpoints was projected for a future Mars exploration mission scenario. Results Here we show appreciable increases in the lifetime risk of exposure-induced death for hematologic malignancies, coronary heart disease, and stroke, which are observed as a function of age after radiation exposure for male and female crew members that are directly attributable to the elevated health risks for CHIP carriers. Conclusions We discuss the importance of evaluating individual risk factors such as CHIP as part of a comprehensive space radiation risk assessment strategy aimed at effective risk communication and disease surveillance for astronauts embarking on future exploration missions.

show abstract

Towards implementation of comprehensive breast cancer risk prediction tools in health care for personalised prevention

Cited by 6 publications

References 51 publications

“For and against” factors influencing participation in personalized breast cancer screening programs: a qualitative systematic review until March 2022

“For and against” factors influencing participation in personalized breast cancer screening programs: a qualitative systematic review until March 2022

Implementing Risk-Stratified Breast Screening in England: An Agenda Setting Meeting

Considering clonal hematopoiesis of indeterminate potential in space radiation risk analysis for hematologic cancers and cardiovascular disease

Contact Info

Product

Resources

About