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Population Attributable Risk of Advanced-Stage Breast Cancer by Race and Ethnicity

BCSC researchers suggest primary prevention can decrease advanced breast cancer diagnoses

Posted by Karla Kerlikowske at 4:30 PM on Dec 12, 2023

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In a new Breast Cancer Surveillance Consortium (BCSC) study published in JAMA Oncology, researchers calculated the population attributable risk proportions (PARPs) for advanced breast cancer by race/ethnicity. Using the large BCSC cohort, the study evaluated 904,615 women aged 40 to 74 (with a median age of 57 years) undergoing 3,331,740 annual or biennial screening mammograms. The study found that regular screening is not always sufficient to prevent an advanced breast cancer diagnosis.

Among routinely screened women, the researchers found that screening frequency was a weak risk factor for advanced cancer and screening biennially vs annually accounted for only a small proportion (2%) of advanced cancer diagnoses in this study population. Being overweight or obese accounted for the largest proportion of advanced cancers in postmenopausal women (30%), while dense breasts accounted for the largest proportion of advanced cancers in pre-menopausal women (37%).

Body mass index PARPs were highest for post-menopausal Black women (38.6%) and Hispanic/Latinx women (31.8%) as well as for pre-menopausal Black women (30.3%). Breast density PARPs were highest for pre-menopausal Asian (46.6%) and White (39.8%) women. For both premenopausal and postmenopausal women, PARPs were small for family history of breast cancer (5% to 8%), history of breast biopsy (7% to 12%) and screening interval (2.1% to 2.3%).

To reduce the number of advanced cancer diagnoses, primary prevention is necessary and should focus on assisting women who are overweight or obese to attain normal weight and educating women on factors that contribute most to development of advanced breast cancer.

 

Kerlikowske K, Chen S, Bissell MCS, Lee CI, Tice JA, Sprague BL, Miglioretti DL. Population Attributable Risk of Advanced-Stage Breast Cancer by Race and Ethnicity. JAMA Oncol. 2023 Dec 7:e235242. doi: 10.1001/jamaoncol.2023.5242. Epub ahead of print. PMID: 38060241; PMCID: PMC10704341. [Link].

 

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Posted by: Karla Kerlikowske