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New Risk Assessment Paradigm to Predict Screening Detection, Failures and False Alarms

新的风险评估范式可预测筛查检测、故障和误报

基本信息

批准号：
9279002
负责人：
KARLA M KERLIKOWSKE
金额：
$ 29.69万
依托单位：
UNIVERSITY OF CALIFORNIA AT DAVIS
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-07-01 至 2022-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9279002
关键词：
Advisory Committees Age American Cancer Society Benign Biopsy Breast Cancer Detection Breast Cancer Risk Factor Breast Cancer Surveillance Consortium Cancer Biology Cessation of life Clinical Clinical/Radiologic Community Practice Community of Practice Consensus Data Decision Making Detection Digital Breast Tomosynthesis Digital Mammography Disease Early Diagnosis Effectiveness Ethnic Origin Failure Frequencies General Population Goals Guidelines Harm Reduction Health Personnel Heterogeneity High Risk Woman Incidence Individual Life Malignant Neoplasms Mammography Masks Modality Modeling Movement Noninfiltrating Intraductal Carcinoma Outcome Output Population Preventive service Primary Health Care Provider Race Radiation exposure Radiation-Induced Cancer Recommendation Regimen Research Infrastructure Research Personnel Risk Risk Assessment Risk Estimate Risk Factors Statistical Methods Subgroup Surveys Testing Woman Women&apos s Health advanced disease aged base breast density cancer invasiveness cancer risk clinical imaging clinical practice clinically actionable comparative effectiveness compare effectiveness cost digital discrete time experience high risk improved innovation lifetime risk malignant breast neoplasm models and simulation mortality novel personalized decision predictive modeling preference radiologist screening secondary outcome tomosynthesis tumor

项目摘要

PROJECT SUMMARY – Project 1 The 2016 US Preventive Services Task Force and 2015 American Cancer Society guidelines call for reduced screening intensity and for providers to discuss with women their preferences for screening. This push for individualized decision-making has triggered substantial movement toward risk-based screening utilization that does not rely solely on a woman's age to determine when to start and stop screening or screening frequency. Yet, the explicit incorporation of risk assessment into screening guidelines for the general population is in its early stages. Risk prediction is a key aspect of risk-based screening; available models predict breast cancer risk overall, but do not take into account the heterogeneity of breast cancer biology or the ability of screening modalities to detect breast cancer. Project 1 aims to advance a new risk-based screening paradigm that identifies women's absolute cumulative risk of screening detection, failures, and false alarms while explicitly considering screening interval and modality used. Aim 1) Using the existing and expanded Breast Cancer Surveillance Consortium (BCSC) infrastructure, project investigators will develop new risk prediction models to identify women at high risk of: 1) early-stage screen-detected cancer (stage I/IIa invasive cancer), 2) screening failure (interval invasive cancer or screen-detected stage IIb or higher), and 3) false alarms (false-positive tests and benign biopsies). Using BCSC data on over 1,000,000 women aged 40-79 years undergoing digital mammography or tomosynthesis, and over 13,000 invasive breast cancers identified, the project team will identify clinical and imaging factors associated with breast cancer risk that impact screening outcomes, generating six-year risk estimates for each screening outcome for annual, biennial, and triennial screening regimens. Aim 2) The project team will identify actionable levels of clinically-meaningful risk of screening failure and false alarm, and associated long-term screening outcomes using women and clinician surveys and Delphi panels. This proposal will answer: 1) Which women are at high risk of screening failures and require an alternative strategy to biennial mammography, and which women are at low risk and can be screened less often? 2) What risk levels of poor screening outcomes impact women and clinician preferences for screening strategies? This project will provide evidence to guide women, health care providers, and policymakers on screening strategies based on short-term risk of screening failures and false alarms with the goal to improve early detection of aggressive tumors while minimizing harms.

项目总结-项目一