Population-Attributable Risk Proportion of Clinical Risk Factors for Breast Cancer.
Population-Attributable Risk Proportion of Clinical Risk Factors for Breast Cancer.
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DOI：
10.1001/jamaoncol.2016.6326
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发表时间：
2017-09-01
期刊：
影响因子：
28.4
通讯作者：
Breast Cancer Surveillance Consortium
中科院分区：
文献类型：
--
作者：
Engmann NJ;Golmakani MK;Miglioretti DL;Sprague BL;Kerlikowske K;Breast Cancer Surveillance Consortium
许多已建立的乳腺癌风险因素被用于临床风险预测模型，尽管这些因素解释的乳腺癌比例尚不清楚。确定绝经前和绝经后妇女中与临床乳腺癌危险因素相关的乳腺癌人群归因风险比例（PARP）。病例对照研究，年龄、风险因素评估年份和乳腺癌监测联盟（BCSC）登记处1：10匹配。从1996年1月1日至2012年10月31日，从BCSC社区乳腺成像设施前瞻性收集风险因素数据。共有18437例浸润性乳腺癌或导管原位癌妇女入选为病例，并与184309例非乳腺癌妇女相匹配，共有58146例绝经前妇女和144600例绝经后妇女入选本研究。乳腺成像报告和数据系统（BI-RADS）乳腺密度（不均匀或极致密vs分散纤维腺体密度）、乳腺癌一级家族史、体重指数（>25 vs 18.5-25）、良性乳腺活检史和未产或首次生育年龄（≥30岁vs <30岁）。乳腺癌的人群归因风险比例。在18437例乳腺癌女性中，绝经前女性的平均（SD）年龄为46.3（3.7）岁，绝经后女性为61.7（7.2）岁。总体而言，4747（89.8%）绝经前和12502（95.1%）绝经后乳腺癌妇女至少有一个乳腺癌的危险因素。所有危险因素的合并PARP在绝经前妇女中为52.7%（95%CI，49.1%-56.3%），在绝经后妇女中为54.7%（95%CI，46.5%-54.7%）。乳腺密度是绝经前和绝经后妇女最普遍的危险因素，对PARP的影响最大;百分之三十九点三（95% CI，36.6%-42.0%）绝经前和26.2%（95% CI，24.4%-28.0%）的绝经后乳腺癌可能会避免，如果所有女性的不均匀或非常致密的乳房转移到分散的乳腺纤维腺体密度。在绝经后妇女中，如果所有超重和肥胖妇女的体重指数低于25，则有22.8%（95% CI，18.3%-27.3%）的乳腺癌可能被避免。大多数患有乳腺癌的女性在乳房X光检查时至少有一个常规记录的乳腺癌风险因素，并且超过一半的绝经前和绝经后乳腺癌可以由这些因素解释。这些容易评估的风险因素应纳入风险预测模型，以分层乳腺癌风险，并促进基于风险的筛查和有针对性的预防工作。
Many established breast cancer risk factors are used in clinical risk prediction models, although the proportion of breast cancers explained by these factors is unknown. To determine the population-attributable risk proportion (PARP) for breast cancer associated with clinical breast cancer risk factors among premenopausal and postmenopausal women. Case-control study with 1:10 matching on age, year of risk factor assessment, and Breast Cancer Surveillance Consortium (BCSC) registry. Risk factor data were collected prospectively from January 1, 1996, through October 31, 2012, from BCSC community-based breast imaging facilities. A total of 18 437 women with invasive breast cancer or ductal carcinoma in situ were enrolled as cases and matched to 184 309 women without breast cancer, with a total of 58 146 premenopausal and 144 600 postmenopausal women enrolled in the study. Breast Imaging Reporting and Data System (BI-RADS) breast density (heterogeneously or extremely dense vs scattered fibroglandular densities), first-degree family history of breast cancer, body mass index (>25 vs 18.5–25), history of benign breast biopsy, and nulliparity or age at first birth (≥30 years vs <30 years). Population-attributable risk proportion of breast cancer. Of the 18 437 women with breast cancer, the mean (SD) age was 46.3 (3.7) years among premenopausal women and 61.7 (7.2) years among the postmenopausal women. Overall, 4747 (89.8%) premenopausal and 12 502 (95.1%) postmenopausal women with breast cancer had at least 1 breast cancer risk factor. The combined PARP of all risk factors was 52.7% (95% CI, 49.1%–56.3%) among premenopausal women and 54.7% (95% CI, 46.5%–54.7%) among postmenopausal women. Breast density was the most prevalent risk factor for both premenopausal and postmenopausal women and had the largest effect on the PARP; 39.3% (95% CI, 36.6%–42.0%) of premenopausal and 26.2% (95% CI, 24.4%–28.0%) of postmenopausal breast cancers could potentially be averted if all women with heterogeneously or extremely dense breasts shifted to scattered fibroglandular breast density. Among postmenopausal women, 22.8% (95% CI, 18.3%–27.3%) of breast cancers could potentially be averted if all overweight and obese women attained a body mass index of less than 25. Most women with breast cancer have at least 1 breast cancer risk factor routinely documented at the time of mammography, and more than half of premenopausal and postmenopausal breast cancers are explained by these factors. These easily assessed risk factors should be incorporated into risk prediction models to stratify breast cancer risk and promote risk-based screening and targeted prevention efforts.
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与立即改变的危险因素相关的白人妇女乳腺癌风险。
影响因子：
3.8
作者：
Clarke, Christina A.;Purdie, David M.;Glaser, Sally L.
通讯作者：
Glaser, Sally L.
DOI：
10.1093/jnci/87.22.1681
发表时间：
1995-11-15
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
MADIGAN, MP;ZIEGLER, RG;HOOVER, RN
通讯作者：
HOOVER, RN
影响因子：
3.8
作者：
Anderson, Kristin N.;Schwab, Richard B.;Martinez, Maria Elena
通讯作者：
Martinez, Maria Elena
DOI：
10.1093/jnci/djk066
发表时间：
2007-03-07
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
Kerlikowske, Karla;Ichikawa, Laura;Ballard-Barbash, Rachel
通讯作者：
Ballard-Barbash, Rachel
影响因子：
2.1
作者：
Hayes, J.;Richardson, A.;Frampton, C.
通讯作者：
Frampton, C.