Validation of the Nigerian Breast Cancer Study Model for Predicting Individual Breast Cancer Risk in Cameroon and Uganda.
Validation of the Nigerian Breast Cancer Study Model for Predicting Individual Breast Cancer Risk in Cameroon and Uganda.
复制标题
DOI：
10.1158/1055-9965.epi-22-0869
复制
发表时间：
2023-01-09
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
尼日利亚乳腺癌研究（NBCS）模型是一种新的风险评估工具，用于预测尼日利亚浸润性乳腺癌的风险。它在尼日利亚以外的适用性仍不确定，因为它尚未在撒哈拉以南非洲的其他人口中得到验证。2011年至2016年，我们在喀麦隆和乌干达确定的乳腺癌女性和对照组中进行了一项病例对照研究。采用结构化问卷访谈收集危险因素特征。分别将NBCS模型、Gail模型、黑人人口Gail模型和黑人妇女健康研究模型应用于喀麦隆和乌干达的样本。尼日利亚和当地的发病率被纳入模型。接收机-操作特性分析进行，以表明判别能力。研究纳入550例（平均年龄47±11.9岁）和509例对照（平均年龄46±11.7岁）。与其他三种模式相比，NBCS模式在两国均表现最佳。喀麦隆（年龄校正C-index = 0.602, 95% CI 0.542 ~ 0.661）的NBCS模型判别准确率优于乌干达（年龄校正C-index = 0.531, 95% CI 0.459 ~ 0.603）。这些发现证明了在喀麦隆进行风险评估的NBCS模型的潜在临床效用。目前所有可用的模型在乌干达都表现不佳，这表明在非洲其他地区使用NBCS模型之前可能需要进一步校准。非洲侨民风险概况的差异强调需要进行更大规模的研究，并且可能需要开发针对特定区域的乳腺癌风险评估工具。
The Nigerian Breast Cancer Study (NBCS) model is a new risk assessment tool developed for predicting risk of invasive breast cancer in Nigeria. Its applicability outside of Nigeria remains uncertain as it has not been validated in other sub-Saharan Africa populations. We conducted a case-control study among women with breast cancer and controls ascertained in Cameroon and Uganda from 2011 to 2016. Structured questionnaire interviews were performed to collect risk factor characteristics. The NBCS model, the Gail model, the Gail model for Black population, and the Black Women’s Health Study model were applied to the Cameroon and Uganda samples separately. Nigerian as well as local incidence rates were incorporated into the models. Receiver-Operating Characteristic analyses were performed to indicate discriminating capacity. The study included 550 cases (mean age 47±11.9) and 509 Controls (mean age 46±11.7). Compared to the other three models, the NBCS model performed best in both countries. The discriminating accuracy of the NBCS model in Cameroon (age-adjusted C-index = 0.602, 95% CI 0.542-0.661) was better than in Uganda (age-adjusted C-index = 0.531, 95% CI, 0.459-0.603). These findings demonstrate the potential clinical utility of the NBCS model for risk assessment in Cameroon. All currently available models performed poorly in Uganda, which suggests that the NBCS model may need further calibration before use in other regions of Africa. Differences in risk profiles across the African diaspora underscores the need for larger studies and may require development of region-specific risk assessment tools for breast cancer.