评估女性个人乳腺癌风险的风险预测模型的预后质量:综述

IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Sarah Wolf, Ingrid Zechmeister-Koss, Irmgard Fruehwirth
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引用次数: 0

摘要

目的。乳腺癌是全球妇女最常见的癌症,2018 年的发病率约为 200 万例。为了更早地发现乳腺癌并降低死亡率,全世界都制定了基于年龄的有组织乳腺癌筛查计划。目前,人们对除年龄外还考虑各种风险因素的风险调整筛查计划充满期待。本研究调查了乳腺癌风险预测模型的判别准确性,以及这些模型是否适合基于风险的筛查计划。研究方法。按照 PICO 计划,我们对综述进行了概述,并系统地检索了四个数据库。所有方法步骤,包括文献选择、数据提取和综合以及质量评估,均按照四眼原则进行。质量评估采用了 AMSTAR 2 工具。结果根据预先确定的纳入标准,我们从 833 篇文献中纳入了 8 篇系统综述。这八篇系统综述包括 99 项主要研究,这些研究也被纳入了数据分析。三篇系统综述被评估为存在高偏倚风险,其他综述被评估为存在中度或低度偏倚风险。大多数已确定的乳腺癌风险预测模型的预后质量较低。加入乳房密度和遗传信息作为风险因素只能适度提高模型的判别准确性。结论迄今为止发表的所有乳腺癌风险预测模型在预测女性个体乳腺癌风险方面的能力都很有限。因此,在国家乳腺癌筛查计划中实施这些模型还为时尚早。有关风险调整乳腺癌筛查计划与传统的基于年龄的计划相比的利弊比,还需要等待相关的随机对照试验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The Prognostic Quality of Risk Prediction Models to Assess the Individual Breast Cancer Risk in Women: An Overview of Reviews

The Prognostic Quality of Risk Prediction Models to Assess the Individual Breast Cancer Risk in Women: An Overview of Reviews

Purpose. Breast cancer is the most common cancer among women globally, with an incidence of approximately two million cases in 2018. Organised age-based breast cancer screening programs were established worldwide to detect breast cancer earlier and to reduce mortality. Currently, there is substantial anticipation regarding risk-adjusted screening programs, considering various risk factors in addition to age. The present study investigated the discriminatory accuracy of breast cancer risk prediction models and whether they suit risk-based screening programs. Methods. Following the PICO scheme, we conducted an overview of reviews and systematically searched four databases. All methodological steps, including the literature selection, data extraction and synthesis, and the quality appraisal were conducted following the 4-eyes principle. For the quality assessment, the AMSTAR 2 tool was used. Results. We included eight systematic reviews out of 833 hits based on the prespecified inclusion criteria. The eight systematic reviews comprised ninety-nine primary studies that were also considered for the data analysis. Three systematic reviews were assessed as having a high risk of bias, while the others were rated with a moderate or low risk of bias. Most identified breast cancer risk prediction models showed a low prognostic quality. Adding breast density and genetic information as risk factors only moderately improved the models’ discriminatory accuracy. Conclusion. All breast cancer risk prediction models published to date show a limited ability to predict the individual breast cancer risk in women. Hence, it is too early to implement them in national breast cancer screening programs. Relevant randomised controlled trials about the benefit-harm ratio of risk-adjusted breast cancer screening programs compared to conventional age-based programs need to be awaited.

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来源期刊
Breast Journal
Breast Journal 医学-妇产科学
CiteScore
4.00
自引率
0.00%
发文量
47
审稿时长
4-8 weeks
期刊介绍: The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include: Risk Factors Prevention Early Detection Diagnosis and Therapy Psychological Issues Quality of Life Biology of Breast Cancer.
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