VALIDATION OF A BREAST-CANCER RISK ASSESSMENT MODEL IN WOMEN WITH A POSITIVE FAMILY HISTORY
VALIDATION OF A BREAST-CANCER RISK ASSESSMENT MODEL IN WOMEN WITH A POSITIVE FAMILY HISTORY
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DOI：
10.1093/jnci/86.8.620
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发表时间：
1994-04-20
期刊：
影响因子：
--
通讯作者：
VOGEL, VG
中科院分区：
文献类型：
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作者：
BONDY, ML;LUSTBADER, ED;VOGEL, VG
背景资料：Gail等人开发了一种统计模型，用于估计每年接受乳房X线摄影筛查的白色女性患乳腺癌的风险。该模型用于咨询和临床试验的准入。目的：我们在一组有乳腺癌家族史的妇女中前瞻性地评估了该模型。方法：我们跟踪了参加美国癌症协会1987年德克萨斯州乳腺癌筛查项目的妇女。通过比较观察到的（O）和预期的（E）乳腺癌数量，使用来自乳腺癌检测和示范项目以及国家癌症研究所的监测、流行病学和最终结果项目的复合背景率，对该模型进行了评估。数据按照美国癌症协会筛查指南进行划分。结果如下：Call等人的模型很好地预测了遵守美国癌症协会指南的女性的风险（O/E = 1.12; 95%置信区间= 0.75-1.61），但过度预测了不遵守指南的女性的风险。有迹象表明，该模型高估了60岁以下女性的风险，低估了60岁及以上女性的风险。结论：总的来说，Gail等人的模型准确地预测了有乳腺癌家族史并遵守美国癌症协会筛查指南的女性的风险。因此，对于每年接受乳房X光检查的妇女，应该按照预期使用该模型。
Background: Gail et al, developed a statistical model for estimating the risk of developing breast cancer in white women screened annually with mammography. This model is used for counseling and for admission to clinical trials. Purpose: We evaluated the model prospectively in a cohort of women with a family history of breast cancer. Methods: We followed women who participated in the American Cancer Society 1987 Texas Breast Screening Project. The model was evaluated by comparing the observed (O) and expected (E) numbers of breast cancers using composite background rates from both the Breast Cancer Detection and Demonstration Project and the Surveillance, Epidemiology, and End Results program of the National Cancer Institute. Data were partitioned by adherence to American Cancer Society screening guidelines. Results: The Call et al, model predicted the risk well among women who adhered to the American Cancer Society guidelines (O/E = 1.12; 95% confidence interval = 0.75-1.61) but overpredicted risk for women who did not adhere to the guidelines. There was an indication that the model overpredicted risk for women younger than 60 years old and underpredicted risk in women aged 60 years and older. Conclusions: Overall, the Gail et al. model accurately predicts risk in women with a family history of breast cancer and who adhere to American Cancer Society screening guidelines. Thus, the model should be used as it was intended, for women who receive annual mammograms.