*For medical professionals only for reference
National Cancer Center launches a risk gadget based on 1.5 million Chinese women's data
Family people, is the bill for Double Eleven? It was just because I took a look in the live broadcast room...
Image source: Internet
But at the time of major merchants fighting, the "national team" National Cancer Center quietly launched a new update on its official website:
Link: http://cancerrc.ncsis.org.cn/#/utilshome
and published relevant research results in the JAMA sub-blog [1]: Based on the country's largest multi-center community screening cohort, covering 1.5 million Chinese women, including 5 recognized breast cancer related risk factors, assessing breast cancer risk levels and relevant screening age suggestions for different individuals.
Research homepage screenshot
No need to spend 1 cent + no brain damage inspection guide + personalized breast cancer risk assessment without saliva explanation + screening age advice. Whether doctors or the public, who can not shout "scent" to this gadget? Then can it become a "hot product"? Where is the "scent" specifically? Let’s take a look at “Product Details” today!
1.5 million Chinese women’s data are created, and the “simple” tools show the precise way!
Evidence consistently shows that screening and early detection can reduce breast cancer mortality. Screening is an indispensable part of the "miracle" of over 90% of breast cancer in the United States' five-year survival. However, most of the current breast cancer screening guidelines recommend screening starting age with a "one-size-fits-all" and age-based approach:
US Preventive Services Task Force (USPSTF) Breast Cancer Screening Guide [2]
"China Breast Cancer Screening and Early Diagnosis Guide" [3]
Faced with a large number of studies that reveal breast cancer risk factors, the "shortcoming" of existing screening guidelines is obvious - individual differences in breast cancer risk have not been fully considered. Therefore, in order to improve the fairness and effectiveness of breast cancer screening, the National Cancer Center has conducted a large-scale study on exploring the risk-adapted starting age of screening for women in China. The
study used data from the China Urban Cancer Screening Project (CanSPUC) and finally included 1549,988 unscreened community-based women aged 40 to 74, without cancer, renal dysfunction or a history of severe heart, brain or lung disease, to collect baseline characteristics related to breast cancer and track breast cancer diagnosis age. The initial age of risk adaptation screening was defined as women with different levels of breast cancer risk, reaching a 10-year cumulative risk level similar to women aged 50 in the general population.
After 4.47 (IQR, 3.16-6.35) years of median follow-up time, 3895 breast cancer patients were diagnosed. In the general population, the risk of breast cancer in women aged 50 years is 2.65% (95% CI, 2.50%-2.76%), and 2.32% (95% CI, 2.19%-2.44%) in women aged 45 years.
risk factors analysis results show that older age, higher BMI, younger menarche, no history of breastfeeding, a history of benign breast diseases and a first-grade family history of breast cancer, is significantly associated with an increased risk of breast cancer.
CanSPUC cohort baseline characteristics of women
According to screening risk factors, the researchers established a multivariable Cox proportional hazard regression model and calculated the risk score of each participant using the following formula:
Risk score = 0.15190× First-level family history of breast cancer + 0.22453× History of benign breast disease – 0.25229× Breast milk Feeding history +0.24038×Meniation age (<13>＜18.5) +0.10798×BMI (24-27.9) +0.22317×BMI (≥28.0)
Comprehensively considering the number of people in each risk classification and the 10-year cumulative risk curve trend, the researchers finally divided the risk score into three risk levels: low, medium and high.
The 10-year cumulative risk of breast cancer in low, medium and high risk women with low risk
compared with the low risk group, women with medium (HR=1.32; 95%CI, 1.24-1.41; P<0.001)>
The risk of breast cancer screening for women with different risk levels is adapted to the starting age
Based on the 10-year cumulative risk of breast cancer at the age of 50 for the general population. Women in the low, medium and high-risk groups of breast cancer reached an equal 10-year cumulative risk of breast cancer at >55, 48 and 43 years old, respectively. The researchers used this to determine the best starting screening age for Chinese women with high, medium and low risk of breast cancer to be 55, 48 and 43 years old, respectively. and developed the online tool mentioned at the beginning of the article. The difficulty of "one-click elimination" evaluation can be said to be so simple that my grandma will use...
"hot product" reservation? There may be these "BUGs" that need to be solved... The biggest highlight of the gadget
is that it sets a personalized screening starting age for Chinese women. High-risk patients can screen early for early diagnosis and treatment to prolong their survival, while low-risk patients also avoid excessive diagnosis and treatment and unnecessary psychological burden. In developing countries where medical resources are still tight, this tool can guide medical resources to the people who need it most and achieve true fairness and effectiveness.
Secondly, This tool includes 5 recognized breast cancer-related risk factors - first-level family history of breast cancer, benign breast disease, breastfeeding, menarche age and body mass index. Although these factors have been taken into account in our existing guidelines, it is worth noting that high-risk women are defined as any of a variety of risk factors, and individuals with more than one risk factor may find it difficult to decide when to conduct screening. This tool will comprehensively score 5 related factors, which is more suitable for clinical use.
Again, compared with the guideline formulated based on expert experience. This study uses real-world data from hospital cases, central cancer registry and medical insurance system to compare the 2020 China Census Yearbook, and the sample size is as high as 1.5 million, ensuring the representativeness and reliability of the analysis, making this tool a truly breast cancer screening tool for Chinese women.
However, the above highlights cannot fully support this tool to promote the national "hot product", and there are still many "bugs" that need to be modified:
1. In terms of risk factors selected for inclusion in the calculation, due to the limited research on the risk factors for breast cancer development in the Chinese population, key variables are still insufficient; and this study did not include risk factors that are more related to breast cancer, such as BRCA1/2 mutation, family history of suggesting such mutations or chest irradiation history, etc. The existence of these risk factors is obviously worth taking more active screening measures.
2. The age "node" in this study is worth discussing. The initial age of risk adaptation was defined as the age at which women with different risk levels reached a 10-year cumulative risk equivalent to women in the general population at the recommended age. However, the study of using 50 years old as the reference standard for screening for Chinese women is not an established fact. And due to the age limits in the population included in this study, some guidelines recommended for women aged 40 or younger were not discussed.
3. Screening strategy not only includes the starting age of screening, but also the screening method and screening interval. Moreover, this study did not evaluate the benefits, disadvantages, feasibility, and personal and health system costs of risk adaptation screening strategies in the Chinese population, but this information is very important for screening guidelines and policy development.
After years of loud voices from the medical community, the concept of "early screening, early diagnosis and treatment" of cancer has been deeply rooted in people's hearts. However, due to the tight per capita medical resources and the difficulty of formulating screening plans, it is still difficult for the public to turn the "action" into "action". In my opinion, the birth of this gadget may be a witness to the transformation of the precise diagnosis and treatment of breast cancer from a high-ranking HARD model led by experts and doctors to an approachable and approachable EASY task in everyone's hands. I look forward to this handy gadget to complete the upgrade as soon as possible and fly into the homes of ordinary people.
References:
[1]Zheng Y, Dong X, Li J, et al.Use of Breast Cancer Risk Factors to Identify Risk-Adapted Starting Age of Screening in China.JAMA Net Open.2022;5(11):e2241441.doi:10.1001/jamanetworkopen.2022.41441
[2]Siu AL;U.S.Preventive Services Task Force.Screening for Breast Cancer:U.S.Preventive Services Task Force Recommendation Statement.Ann Intern Med.2016 Feb 16;164(4):279-96.doi:10.7326/M15-2886.Epub 2016 Jan 12.Erratum in:Ann Intern Med.2016 Mar 15;164(6):448.PMID:26757170.
[3]Breast Cancer Professional Committee of China Anti-Cancer Association. Guidelines for Chinese Breast Cancer Screening and Early Diagnosis [J]. Chinese Cancer Journal, 2022, 32(4):363-372.
This article is first published: Medical World Tumor Channel
Author of this article: Lily
Editor: Sweet
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