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SUMMARY:Implementation of risk stratified breast cancer screening: Lessons
  learned from the PERSPECTIVE I&I Project - Professor Jacques Simard\,  Ph
 D\, FRSC\, FCAHS
DTSTART:20240228T143000Z
DTEND:20240228T153000Z
UID:TALK212461@talks.cam.ac.uk
CONTACT:Sarah Gordon
DESCRIPTION:In Canada\, women ages 50 to 74 are recommended to have a mamm
 ogram every 2 to 3 years. Risk-stratified breast screening has been propos
 ed as a strategy to overcome the limitations of age-based screening. Takin
 g advantage of risk stratification tools developed as part of the first ph
 ase of PERSPECTIVE\, the Personalized Risk Assessment for Prevention and E
 arly Detection of Breast Cancer: Integration and Implementation (PERSPECTI
 VE I&I) study aims to produce evidence on the feasibility\, acceptability\
 , adoption and cost-effectiveness of a screening approach based on individ
 ual risk in order to generate the first Canadian real-world evidence suppo
 rting implementation of risk-stratified screening (Brooks et al. J Pers Me
 d. 2021\; 11(6): 511).\n \nThe study recruited unaffected women aged 40-69
  years old who had a mammogram. The comprehensive CanRisk prediction tool 
 (Lee et al. Genetics in Medicine\, 2019\, 21(8) 1708-1718\; www.canrisk.or
 g) was used to estimate a 10-year risk of breast cancer.\nThe resulting ri
 sk estimates were then stratified into 3 categories using absolute risk th
 resholds that vary depending on the age of the participants (Pashayan et a
 l. J Pers Med.2021 11 (9): 916) namely: average risk\, higher than average
  risk and high risk\, which correspond to a residual lifetime risk of brea
 st cancer (30 to 80 years) of <15%\, 15 to 24% and ≥25% respectively.  A
 mong the 3\,753 participants for whom a risk of breast cancer was calculat
 ed\, 79.8% had an average risk\, 15.5% had a higher than average risk and 
 4.4% had a high risk.\nUsing multifactorial risk levels compared to age\, 
 family history or breast density alone may provide more appropriate recomm
 endations by reducing over screening in those at average risk and adapting
  screening modalities for those at higher risk.\n \nResults demonstrates t
 he feasibility of risk assessment for stratified population-level screenin
 g\, but highlights some potential challenges and considerations for recrui
 tment and data collection. Implementation should incorporate an equity len
 s to ensure cancer screening disparities are not widened. This study also 
 indicates that risk-based screening is acceptable to women and that there 
 is no evidence of adverse psychological outcomes of stratified breast canc
 er risk communication up to one year after disclosure.\n
LOCATION:Dorothy & Thomas Room\, Strangeways Research Lab
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