Implementing Multifactorial Risk Assessment with Polygenic Risk Scores for Personalized Breast Cancer Screening in the Population Setting: Challenges and Opportunities
Risk-stratified breast screening has been proposed as a strategy to overcome the limitations of age-based screening. A prospective cohort study was undertaken within the PERSPECTIVE I&I project, which will generate the first Canadian evidence on multifactorial breast cancer risk assessment in th...
Saved in:
| Published in | Cancers Vol. 16; no. 11; p. 2116 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Switzerland
MDPI AG
01.06.2024
MDPI |
| Subjects | |
| Online Access | Get full text |
Cover
Loading…
| Abstract | Risk-stratified breast screening has been proposed as a strategy to overcome the limitations of age-based screening. A prospective cohort study was undertaken within the PERSPECTIVE I&I project, which will generate the first Canadian evidence on multifactorial breast cancer risk assessment in the population setting to inform the implementation of risk-stratified screening. Recruited females aged 40-69 unaffected by breast cancer, with a previous mammogram, underwent multifactorial breast cancer risk assessment. The adoption of multifactorial risk assessment, the effectiveness of methods for collecting risk factor information and the costs of risk assessment were examined. Associations between participant characteristics and study sites, as well as data collection methods, were assessed using logistic regression; all
-values are two-sided. Of the 4246 participants recruited, 88.4% completed a risk assessment, with 79.8%, 15.7% and 4.4% estimated at average, higher than average and high risk, respectively. The total per-participant cost for risk assessment was CAD 315. Participants who chose to provide risk factor information on paper/telephone (27.2%) vs. online were more likely to be older (
= 0.021), not born in Canada (
= 0.043), visible minorities (
= 0.01) and have a lower attained education (
< 0.0001) and perceived fair/poor health (
< 0.001). The 34.4% of participants requiring risk factor verification for missing/unusual values were more likely to be visible minorities (
= 0.009) and have a lower attained education (
≤ 0.006). This study demonstrates the feasibility of risk assessment for risk-stratified screening at the population level. Implementation should incorporate an equity lens to ensure cancer-screening disparities are not widened. |
|---|---|
| AbstractList | The current approach to breast cancer screening, which is based on a person’s age, overlooks individual-level differences in breast cancer risk. As a result, many people are over- or under-screened according to their actual risk of breast cancer. Risk-stratified breast screening may overcome the limitations of age-based screening, but there are still many knowledge gaps regarding how best to implement it in the population setting. This study will generate the first Canadian evidence on the adoption of breast cancer risk assessment in the population setting, to support the future implementation of risk-stratified breast cancer screening. This study demonstrated that, while risk assessment for risk-stratified screening at the population level is feasible, an equity lens must be considered in implementation to ensure cancer-screening disparities are not widened. Risk-stratified breast screening has been proposed as a strategy to overcome the limitations of age-based screening. A prospective cohort study was undertaken within the PERSPECTIVE I&I project, which will generate the first Canadian evidence on multifactorial breast cancer risk assessment in the population setting to inform the implementation of risk-stratified screening. Recruited females aged 40-69 unaffected by breast cancer, with a previous mammogram, underwent multifactorial breast cancer risk assessment. The adoption of multifactorial risk assessment, the effectiveness of methods for collecting risk factor information and the costs of risk assessment were examined. Associations between participant characteristics and study sites, as well as data collection methods, were assessed using logistic regression; all p-values are two-sided. Of the 4246 participants recruited, 88.4% completed a risk assessment, with 79.8%, 15.7% and 4.4% estimated at average, higher than average and high risk, respectively. The total per-participant cost for risk assessment was CAD 315. Participants who chose to provide risk factor information on paper/telephone (27.2%) vs. online were more likely to be older (p = 0.021), not born in Canada (p = 0.043), visible minorities (p = 0.01) and have a lower attained education (p < 0.0001) and perceived fair/poor health (p < 0.001). The 34.4% of participants requiring risk factor verification for missing/unusual values were more likely to be visible minorities (p = 0.009) and have a lower attained education (p ≤ 0.006). This study demonstrates the feasibility of risk assessment for risk-stratified screening at the population level. Implementation should incorporate an equity lens to ensure cancer-screening disparities are not widened.Risk-stratified breast screening has been proposed as a strategy to overcome the limitations of age-based screening. A prospective cohort study was undertaken within the PERSPECTIVE I&I project, which will generate the first Canadian evidence on multifactorial breast cancer risk assessment in the population setting to inform the implementation of risk-stratified screening. Recruited females aged 40-69 unaffected by breast cancer, with a previous mammogram, underwent multifactorial breast cancer risk assessment. The adoption of multifactorial risk assessment, the effectiveness of methods for collecting risk factor information and the costs of risk assessment were examined. Associations between participant characteristics and study sites, as well as data collection methods, were assessed using logistic regression; all p-values are two-sided. Of the 4246 participants recruited, 88.4% completed a risk assessment, with 79.8%, 15.7% and 4.4% estimated at average, higher than average and high risk, respectively. The total per-participant cost for risk assessment was CAD 315. Participants who chose to provide risk factor information on paper/telephone (27.2%) vs. online were more likely to be older (p = 0.021), not born in Canada (p = 0.043), visible minorities (p = 0.01) and have a lower attained education (p < 0.0001) and perceived fair/poor health (p < 0.001). The 34.4% of participants requiring risk factor verification for missing/unusual values were more likely to be visible minorities (p = 0.009) and have a lower attained education (p ≤ 0.006). This study demonstrates the feasibility of risk assessment for risk-stratified screening at the population level. Implementation should incorporate an equity lens to ensure cancer-screening disparities are not widened. Simple SummaryThe current approach to breast cancer screening, which is based on a person’s age, overlooks individual-level differences in breast cancer risk. As a result, many people are over- or under-screened according to their actual risk of breast cancer. Risk-stratified breast screening may overcome the limitations of age-based screening, but there are still many knowledge gaps regarding how best to implement it in the population setting. This study will generate the first Canadian evidence on the adoption of breast cancer risk assessment in the population setting, to support the future implementation of risk-stratified breast cancer screening. This study demonstrated that, while risk assessment for risk-stratified screening at the population level is feasible, an equity lens must be considered in implementation to ensure cancer-screening disparities are not widened.AbstractRisk-stratified breast screening has been proposed as a strategy to overcome the limitations of age-based screening. A prospective cohort study was undertaken within the PERSPECTIVE I&I project, which will generate the first Canadian evidence on multifactorial breast cancer risk assessment in the population setting to inform the implementation of risk-stratified screening. Recruited females aged 40–69 unaffected by breast cancer, with a previous mammogram, underwent multifactorial breast cancer risk assessment. The adoption of multifactorial risk assessment, the effectiveness of methods for collecting risk factor information and the costs of risk assessment were examined. Associations between participant characteristics and study sites, as well as data collection methods, were assessed using logistic regression; all p-values are two-sided. Of the 4246 participants recruited, 88.4% completed a risk assessment, with 79.8%, 15.7% and 4.4% estimated at average, higher than average and high risk, respectively. The total per-participant cost for risk assessment was CAD 315. Participants who chose to provide risk factor information on paper/telephone (27.2%) vs. online were more likely to be older (p = 0.021), not born in Canada (p = 0.043), visible minorities (p = 0.01) and have a lower attained education (p < 0.0001) and perceived fair/poor health (p < 0.001). The 34.4% of participants requiring risk factor verification for missing/unusual values were more likely to be visible minorities (p = 0.009) and have a lower attained education (p ≤ 0.006). This study demonstrates the feasibility of risk assessment for risk-stratified screening at the population level. Implementation should incorporate an equity lens to ensure cancer-screening disparities are not widened. The current approach to breast cancer screening, which is based on a person’s age, overlooks individual-level differences in breast cancer risk. As a result, many people are over- or under-screened according to their actual risk of breast cancer. Risk-stratified breast screening may overcome the limitations of age-based screening, but there are still many knowledge gaps regarding how best to implement it in the population setting. This study will generate the first Canadian evidence on the adoption of breast cancer risk assessment in the population setting, to support the future implementation of risk-stratified breast cancer screening. This study demonstrated that, while risk assessment for risk-stratified screening at the population level is feasible, an equity lens must be considered in implementation to ensure cancer-screening disparities are not widened. Risk-stratified breast screening has been proposed as a strategy to overcome the limitations of age-based screening. A prospective cohort study was undertaken within the PERSPECTIVE I&I project, which will generate the first Canadian evidence on multifactorial breast cancer risk assessment in the population setting to inform the implementation of risk-stratified screening. Recruited females aged 40–69 unaffected by breast cancer, with a previous mammogram, underwent multifactorial breast cancer risk assessment. The adoption of multifactorial risk assessment, the effectiveness of methods for collecting risk factor information and the costs of risk assessment were examined. Associations between participant characteristics and study sites, as well as data collection methods, were assessed using logistic regression; all p -values are two-sided. Of the 4246 participants recruited, 88.4% completed a risk assessment, with 79.8%, 15.7% and 4.4% estimated at average, higher than average and high risk, respectively. The total per-participant cost for risk assessment was CAD 315. Participants who chose to provide risk factor information on paper/telephone (27.2%) vs. online were more likely to be older (p = 0.021), not born in Canada (p = 0.043), visible minorities (p = 0.01) and have a lower attained education (p < 0.0001) and perceived fair/poor health (p < 0.001). The 34.4% of participants requiring risk factor verification for missing/unusual values were more likely to be visible minorities (p = 0.009) and have a lower attained education (p ≤ 0.006). This study demonstrates the feasibility of risk assessment for risk-stratified screening at the population level. Implementation should incorporate an equity lens to ensure cancer-screening disparities are not widened. Risk-stratified breast screening has been proposed as a strategy to overcome the limitations of age-based screening. A prospective cohort study was undertaken within the PERSPECTIVE I&I project, which will generate the first Canadian evidence on multifactorial breast cancer risk assessment in the population setting to inform the implementation of risk-stratified screening. Recruited females aged 40–69 unaffected by breast cancer, with a previous mammogram, underwent multifactorial breast cancer risk assessment. The adoption of multifactorial risk assessment, the effectiveness of methods for collecting risk factor information and the costs of risk assessment were examined. Associations between participant characteristics and study sites, as well as data collection methods, were assessed using logistic regression; all p-values are two-sided. Of the 4246 participants recruited, 88.4% completed a risk assessment, with 79.8%, 15.7% and 4.4% estimated at average, higher than average and high risk, respectively. The total per-participant cost for risk assessment was CAD 315. Participants who chose to provide risk factor information on paper/telephone (27.2%) vs. online were more likely to be older (p = 0.021), not born in Canada (p = 0.043), visible minorities (p = 0.01) and have a lower attained education (p < 0.0001) and perceived fair/poor health (p < 0.001). The 34.4% of participants requiring risk factor verification for missing/unusual values were more likely to be visible minorities (p = 0.009) and have a lower attained education (p ≤ 0.006). This study demonstrates the feasibility of risk assessment for risk-stratified screening at the population level. Implementation should incorporate an equity lens to ensure cancer-screening disparities are not widened. Risk-stratified breast screening has been proposed as a strategy to overcome the limitations of age-based screening. A prospective cohort study was undertaken within the PERSPECTIVE I&I project, which will generate the first Canadian evidence on multifactorial breast cancer risk assessment in the population setting to inform the implementation of risk-stratified screening. Recruited females aged 40-69 unaffected by breast cancer, with a previous mammogram, underwent multifactorial breast cancer risk assessment. The adoption of multifactorial risk assessment, the effectiveness of methods for collecting risk factor information and the costs of risk assessment were examined. Associations between participant characteristics and study sites, as well as data collection methods, were assessed using logistic regression; all -values are two-sided. Of the 4246 participants recruited, 88.4% completed a risk assessment, with 79.8%, 15.7% and 4.4% estimated at average, higher than average and high risk, respectively. The total per-participant cost for risk assessment was CAD 315. Participants who chose to provide risk factor information on paper/telephone (27.2%) vs. online were more likely to be older ( = 0.021), not born in Canada ( = 0.043), visible minorities ( = 0.01) and have a lower attained education ( < 0.0001) and perceived fair/poor health ( < 0.001). The 34.4% of participants requiring risk factor verification for missing/unusual values were more likely to be visible minorities ( = 0.009) and have a lower attained education ( ≤ 0.006). This study demonstrates the feasibility of risk assessment for risk-stratified screening at the population level. Implementation should incorporate an equity lens to ensure cancer-screening disparities are not widened. |
| Audience | Academic |
| Author | Brooks, Jennifer D Paquette, Jean-Sébastien Després, Philippe Broeders, Mireille J M Kim, Shana J Knoppers, Bartha M Sheppard, Amanda J Lofters, Aisha K Chiquette, Jocelyne Turgeon, Annie Nabi, Hermann Blackmore, Kristina M Lambert-Côté, Laurence Easton, Douglas F Pashayan, Nora Dorval, Michel Chiarelli, Anna M Walker, Meghan J Chang, Amy Evans, D Gareth Bell, Kathleen A Fienberg, Samantha Eisen, Andrea Simard, Jacques Eloy, Laurence Kim, Raymond H Antoniou, Antonis C Joly, Yann Carver, Tim Stockley, Tracy L |
| AuthorAffiliation | 17 Division of Clinical Laboratory Genetics, University Health Network, Toronto, ON M5G 2C4, Canada 6 Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, QC G1V 0A6, Canada; jean-sebastien.paquette@fmed.ulaval.ca 8 Sunnybrook Health Science Center, Toronto, ON M4N 3M5, Canada 11 Centre of Genomics and Policy, McGill University, Montreal, QC H3A 0G1, Canada 10 Division of Evolution Infection and Genomic Sciences, The University of Manchester, Manchester M13 9PL, UK 7 Department of Physics, Engineering Physics and Optics, Faculty of Science and Engineering, Université Laval, Quebec City, QC G1V 0A6, Canada 13 Women’s College Research Institute, Toronto, ON M5G 1N8, Canada 1 Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada 18 Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada 20 Department of Molecular Medicine, Faculty of Medicine, Université Laval, Quebec City, QC G1V 4G2, C |
| AuthorAffiliation_xml | – name: 9 Québec Cancer Program, Ministère de la Santé et des Services Sociaux, Quebec City, QC G1S 2M1, Canada – name: 14 Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada – name: 12 Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada – name: 2 Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada – name: 6 Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, QC G1V 0A6, Canada; jean-sebastien.paquette@fmed.ulaval.ca – name: 7 Department of Physics, Engineering Physics and Optics, Faculty of Science and Engineering, Université Laval, Quebec City, QC G1V 0A6, Canada – name: 16 Department of Applied Health Research, Institute of Epidemiology and Healthcare, University College London, London WC1E 6BT, UK – name: 19 Faculty of Pharmacy, Université Laval, Quebec City, QC G1V 0A6, Canada – name: 13 Women’s College Research Institute, Toronto, ON M5G 1N8, Canada – name: 4 Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge CB1 8RN, UK – name: 15 Université Laval Cancer Research Center, Quebec City, QC G1R 3S3, Canada – name: 3 CHU de Québec-Université Laval Research Center, Queébec City, QC G1V 4G2, Canada – name: 17 Division of Clinical Laboratory Genetics, University Health Network, Toronto, ON M5G 2C4, Canada – name: 8 Sunnybrook Health Science Center, Toronto, ON M4N 3M5, Canada – name: 10 Division of Evolution Infection and Genomic Sciences, The University of Manchester, Manchester M13 9PL, UK – name: 5 Department for Health Evidence, Radboud University Medical Center, 6525EP Nijmegen, The Netherlands – name: 1 Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada – name: 20 Department of Molecular Medicine, Faculty of Medicine, Université Laval, Quebec City, QC G1V 4G2, Canada – name: 11 Centre of Genomics and Policy, McGill University, Montreal, QC H3A 0G1, Canada – name: 18 Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada |
| Author_xml | – sequence: 1 givenname: Meghan J orcidid: 0000-0003-4189-7507 surname: Walker fullname: Walker, Meghan J organization: Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada – sequence: 2 givenname: Kristina M surname: Blackmore fullname: Blackmore, Kristina M organization: Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada – sequence: 3 givenname: Amy surname: Chang fullname: Chang, Amy organization: Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada – sequence: 4 givenname: Laurence orcidid: 0000-0003-2598-7094 surname: Lambert-Côté fullname: Lambert-Côté, Laurence organization: CHU de Québec-Université Laval Research Center, Queébec City, QC G1V 4G2, Canada – sequence: 5 givenname: Annie orcidid: 0009-0006-7816-6133 surname: Turgeon fullname: Turgeon, Annie organization: CHU de Québec-Université Laval Research Center, Queébec City, QC G1V 4G2, Canada – sequence: 6 givenname: Antonis C surname: Antoniou fullname: Antoniou, Antonis C organization: Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge CB1 8RN, UK – sequence: 7 givenname: Kathleen A surname: Bell fullname: Bell, Kathleen A organization: Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada – sequence: 8 givenname: Mireille J M orcidid: 0000-0002-8741-8148 surname: Broeders fullname: Broeders, Mireille J M organization: Department for Health Evidence, Radboud University Medical Center, 6525EP Nijmegen, The Netherlands – sequence: 9 givenname: Jennifer D orcidid: 0000-0001-7574-4256 surname: Brooks fullname: Brooks, Jennifer D organization: Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada – sequence: 10 givenname: Tim surname: Carver fullname: Carver, Tim organization: Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge CB1 8RN, UK – sequence: 11 givenname: Jocelyne surname: Chiquette fullname: Chiquette, Jocelyne organization: Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, QC G1V 0A6, Canada – sequence: 12 givenname: Philippe orcidid: 0000-0002-4163-7353 surname: Després fullname: Després, Philippe organization: Department of Physics, Engineering Physics and Optics, Faculty of Science and Engineering, Université Laval, Quebec City, QC G1V 0A6, Canada – sequence: 13 givenname: Douglas F surname: Easton fullname: Easton, Douglas F organization: Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge CB1 8RN, UK – sequence: 14 givenname: Andrea surname: Eisen fullname: Eisen, Andrea organization: Sunnybrook Health Science Center, Toronto, ON M4N 3M5, Canada – sequence: 15 givenname: Laurence surname: Eloy fullname: Eloy, Laurence organization: Québec Cancer Program, Ministère de la Santé et des Services Sociaux, Quebec City, QC G1S 2M1, Canada – sequence: 16 givenname: D Gareth orcidid: 0000-0002-8482-5784 surname: Evans fullname: Evans, D Gareth organization: Division of Evolution Infection and Genomic Sciences, The University of Manchester, Manchester M13 9PL, UK – sequence: 17 givenname: Samantha surname: Fienberg fullname: Fienberg, Samantha organization: Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada – sequence: 18 givenname: Yann surname: Joly fullname: Joly, Yann organization: Centre of Genomics and Policy, McGill University, Montreal, QC H3A 0G1, Canada – sequence: 19 givenname: Raymond H orcidid: 0000-0002-2147-8674 surname: Kim fullname: Kim, Raymond H organization: Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada – sequence: 20 givenname: Shana J orcidid: 0009-0008-8816-5518 surname: Kim fullname: Kim, Shana J organization: Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada – sequence: 21 givenname: Bartha M orcidid: 0000-0001-7004-2722 surname: Knoppers fullname: Knoppers, Bartha M organization: Centre of Genomics and Policy, McGill University, Montreal, QC H3A 0G1, Canada – sequence: 22 givenname: Aisha K surname: Lofters fullname: Lofters, Aisha K organization: Women's College Research Institute, Toronto, ON M5G 1N8, Canada – sequence: 23 givenname: Hermann surname: Nabi fullname: Nabi, Hermann organization: Université Laval Cancer Research Center, Quebec City, QC G1R 3S3, Canada – sequence: 24 givenname: Jean-Sébastien orcidid: 0000-0002-9524-6761 surname: Paquette fullname: Paquette, Jean-Sébastien organization: Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, QC G1V 0A6, Canada – sequence: 25 givenname: Nora surname: Pashayan fullname: Pashayan, Nora organization: Department of Applied Health Research, Institute of Epidemiology and Healthcare, University College London, London WC1E 6BT, UK – sequence: 26 givenname: Amanda J surname: Sheppard fullname: Sheppard, Amanda J organization: Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada – sequence: 27 givenname: Tracy L orcidid: 0000-0002-4476-9722 surname: Stockley fullname: Stockley, Tracy L organization: Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada – sequence: 28 givenname: Michel orcidid: 0000-0002-3207-8211 surname: Dorval fullname: Dorval, Michel organization: Faculty of Pharmacy, Université Laval, Quebec City, QC G1V 0A6, Canada – sequence: 29 givenname: Jacques orcidid: 0000-0001-6906-3390 surname: Simard fullname: Simard, Jacques organization: Department of Molecular Medicine, Faculty of Medicine, Université Laval, Quebec City, QC G1V 4G2, Canada – sequence: 30 givenname: Anna M surname: Chiarelli fullname: Chiarelli, Anna M organization: Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38893236$$D View this record in MEDLINE/PubMed |
| BookMark | eNptkk1vEzEQhleoiJbSMzdkiQuXFH9s7DUXFCI-IhW1onBeeb3jjYPXTm0vqPwh_iZOU6BF2AdbM-88M2PP4-rABw9V9ZTgU8YkfqmV1xAT4YRQQviD6ohiQWecy_rgzv2wOklpg8tijAguHlWHrGkko4wfVT9X49bBCD5bP6CPk8vWKJ1DtMqhTzZ9RYuUIKWdAn23eY0ugrsewFu9d1_qECEhEyK6KMUEr5z9AT16E0GljJY3NRZVhBJTUliP8hoKZTs5lW3w6BLyLvkrtFwr58APBad8j8632xDz5G22kJ5UD41yCU5uz-Pqy7u3n5cfZmfn71fLxdmsZ1LmWQe9JHPoMBe0NlwTamjTU96BVkYI2WNQtK7BdEAFZlLUnZpjrLHEwnBl2HG12nP7oDbtNtpRxes2KNveGEIcWhWz1Q7aRvEGiNSCNaZWUneKaU6NgLqHXnd1Yb3es7ZTNxZTecKo3D3ofY-363YI31pCiCBzMi-EF7eEGK4mSLkdbdLgnPIQptQyLHCDiaS0SJ__I92EKZbf2Kl4qZGxuvmrGlTpwHoTSmK9g7YLIUUjJWGsqE7_oyq7h9HqMoTGFvu9gGd3O_3T4u85Y78AZq7b_g |
| ContentType | Journal Article |
| Copyright | COPYRIGHT 2024 MDPI AG 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2024 by the authors. 2024 |
| Copyright_xml | – notice: COPYRIGHT 2024 MDPI AG – notice: 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: 2024 by the authors. 2024 |
| DBID | NPM 3V. 7T5 7TO 7XB 8FE 8FH 8FK 8G5 ABUWG AFKRA AZQEC BBNVY BENPR BHPHI CCPQU COVID DWQXO GNUQQ GUQSH H94 HCIFZ LK8 M2O M7P MBDVC PIMPY PQEST PQQKQ PQUKI PRINS Q9U 7X8 5PM DOA |
| DOI | 10.3390/cancers16112116 |
| DatabaseName | PubMed ProQuest Central (Corporate) Immunology Abstracts Oncogenes and Growth Factors Abstracts ProQuest Central (purchase pre-March 2016) ProQuest SciTech Collection ProQuest Natural Science Collection ProQuest Central (Alumni) (purchase pre-March 2016) Research Library (Alumni Edition) ProQuest Central (Alumni) ProQuest Central ProQuest Central Essentials Biological Science Collection AUTh Library subscriptions: ProQuest Central Natural Science Collection ProQuest One Community College Coronavirus Research Database ProQuest Central Korea ProQuest Central Student Research Library Prep AIDS and Cancer Research Abstracts SciTech Premium Collection Biological Sciences Research Library Biological Science Database Research Library (Corporate) Publicly Available Content Database ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Academic ProQuest One Academic UKI Edition ProQuest Central China ProQuest Central Basic MEDLINE - Academic PubMed Central (Full Participant titles) Directory of Open Access Journals |
| DatabaseTitle | PubMed Publicly Available Content Database Research Library Prep ProQuest Central Student Oncogenes and Growth Factors Abstracts ProQuest Central Essentials ProQuest Central (Alumni Edition) SciTech Premium Collection ProQuest One Community College Research Library (Alumni Edition) ProQuest Natural Science Collection ProQuest Central China ProQuest Central Natural Science Collection ProQuest Central Korea Biological Science Collection AIDS and Cancer Research Abstracts ProQuest Research Library ProQuest Biological Science Collection ProQuest Central Basic ProQuest One Academic Eastern Edition Coronavirus Research Database Biological Science Database ProQuest SciTech Collection ProQuest One Academic UKI Edition Immunology Abstracts ProQuest One Academic ProQuest Central (Alumni) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE - Academic Publicly Available Content Database PubMed |
| Database_xml | – sequence: 1 dbid: DOA name: DOAJ Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website – sequence: 2 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 3 dbid: BENPR name: ProQuest Central url: https://www.proquest.com/central sourceTypes: Aggregation Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 2072-6694 |
| ExternalDocumentID | oai_doaj_org_article_8a68e19c738f4a9cba3c62f7e4dedcb4 A797899133 38893236 |
| Genre | Journal Article |
| GeographicLocations | Canada Quebec Canada |
| GeographicLocations_xml | – name: Canada – name: Quebec Canada |
| GrantInformation_xml | – fundername: Genome Canada grantid: 13529 – fundername: Génome Québec grantid: N/A – fundername: Quebec Breast Cancer Foundation grantid: N/A – fundername: CHU de Québec-Université Laval Research Center grantid: N/A – fundername: the CHU de Québec Foundation grantid: N/A – fundername: Ontario Research Fund grantid: N/A – fundername: CIHR grantid: 155865 – fundername: Cancer Research UK grantid: PPRPGM-Nov20\100002 – fundername: the CHU de Québec Foundation – fundername: the CHU de Québec–Université Laval Research Center – fundername: the Canadian Institutes for Health Research grantid: #155865 – fundername: the Québec Breast Cancer Foundation – fundername: the Québec Ministry of Economy, Science and Innovation through Génome Québec |
| GroupedDBID | --- 3V. 53G 5VS 8FE 8FH 8G5 AADQD AAFWJ ABDBF ABUWG ADBBV AFKRA AFZYC ALMA_UNASSIGNED_HOLDINGS AOIJS AZQEC BAWUL BBNVY BCNDV BENPR BHPHI BPHCQ CCPQU DIK DWQXO E3Z EBD ESX GNUQQ GROUPED_DOAJ GUQSH GX1 HCIFZ HYE IAO IHR ITC KQ8 LK8 M2O M48 M7P MODMG M~E NPM OK1 P6G PGMZT PIMPY PQQKQ PROAC RIG RPM TUS AFPKN 7T5 7TO 7XB 8FK COVID H94 MBDVC PQEST PQUKI PRINS Q9U 7X8 5PM |
| ID | FETCH-LOGICAL-d399t-bed915eb06724f6c12f28d26becaf779d0ea244efbe2703974ba500c0907f6af3 |
| IEDL.DBID | RPM |
| ISSN | 2072-6694 |
| IngestDate | Fri Oct 04 13:11:07 EDT 2024 Tue Sep 17 21:28:45 EDT 2024 Sat Aug 17 04:42:20 EDT 2024 Thu Oct 10 16:33:10 EDT 2024 Wed Jun 26 19:26:57 EDT 2024 Tue Jun 25 19:22:16 EDT 2024 Fri Oct 18 08:46:43 EDT 2024 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 11 |
| Keywords | risk assessment breast cancer breast cancer screening risk stratification polygenic risk score implementation |
| Language | English |
| License | Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-d399t-bed915eb06724f6c12f28d26becaf779d0ea244efbe2703974ba500c0907f6af3 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These authors contributed equally to this work. |
| ORCID | 0000-0003-2598-7094 0000-0002-9524-6761 0000-0002-3207-8211 0000-0002-8741-8148 0009-0008-8816-5518 0000-0002-4476-9722 0000-0001-6906-3390 0000-0002-8482-5784 0000-0001-7574-4256 0000-0003-4189-7507 0009-0006-7816-6133 0000-0002-2147-8674 0000-0002-4163-7353 0000-0001-7004-2722 |
| OpenAccessLink | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11171515/ |
| PMID | 38893236 |
| PQID | 3067383348 |
| PQPubID | 2032421 |
| ParticipantIDs | doaj_primary_oai_doaj_org_article_8a68e19c738f4a9cba3c62f7e4dedcb4 pubmedcentral_primary_oai_pubmedcentral_nih_gov_11171515 proquest_miscellaneous_3070801922 proquest_journals_3067383348 gale_infotracmisc_A797899133 gale_infotracacademiconefile_A797899133 pubmed_primary_38893236 |
| PublicationCentury | 2000 |
| PublicationDate | 2024-06-01 |
| PublicationDateYYYYMMDD | 2024-06-01 |
| PublicationDate_xml | – month: 06 year: 2024 text: 2024-06-01 day: 01 |
| PublicationDecade | 2020 |
| PublicationPlace | Switzerland |
| PublicationPlace_xml | – name: Switzerland – name: Basel |
| PublicationTitle | Cancers |
| PublicationTitleAlternate | Cancers (Basel) |
| PublicationYear | 2024 |
| Publisher | MDPI AG MDPI |
| Publisher_xml | – name: MDPI AG – name: MDPI |
| SSID | ssj0000331767 |
| Score | 2.3904212 |
| Snippet | Risk-stratified breast screening has been proposed as a strategy to overcome the limitations of age-based screening. A prospective cohort study was undertaken... The current approach to breast cancer screening, which is based on a person’s age, overlooks individual-level differences in breast cancer risk. As a result,... Simple SummaryThe current approach to breast cancer screening, which is based on a person’s age, overlooks individual-level differences in breast cancer risk.... |
| SourceID | doaj pubmedcentral proquest gale pubmed |
| SourceType | Open Website Open Access Repository Aggregation Database Index Database |
| StartPage | 2116 |
| SubjectTerms | Age Alcohol use Births Breast cancer breast cancer screening Cancer Cancer screening Cohort analysis Communication Data collection Diagnosis Family medical history Feasibility studies Genetic aspects Genetic testing implementation Mammography Medical screening Methods Oncology, Experimental Ovaries Pancreatic cancer polygenic risk score Population studies Primary care Questionnaires Risk assessment Risk factors risk stratification Social networks Sociodemographics |
| SummonAdditionalLinks | – databaseName: Directory of Open Access Journals dbid: DOA link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1Lb9QwELZQD4gLAsojUCojIXGKuo6d2OG2XbWqKhUqSqXeIj9hVeStmt0D_CH-JjN2stqIAxdOkWInsT0z9jfx-BtC3jvmZ1zUrrRspkrBDCt1i9x4XIRWG254jaeRLz41Z9fi_Ka-2Un1hTFhmR44D9yR0o3yrLWSqyB0a43mtqmC9MJ5Z01mAmX1jjOV5mAO62IjM5cPB7_-yOIg3vcAcJDUbKTo_3si3lmJplGSO8vO6RPyeMCLdJ7b-ZQ88PEZeXgx7Ijvk9-J3jfF_MRvNB2nzSl0QK_ol2V_S-db7k2KP13p5erHT9Capc3FV8hj2VPArvRyBOa_vKPHGK2-povUIaiF8Tn4iWWkgBnhLWPiL3rlU-z0R7oYE7P0VEdHP98htt_ExNn6nFyfnnxdnJVD8oXSAWZZl8a7ltXe4FatCI1lVaiUqxqQuQ5Stm7mNUADH4yvYNYAt8RgcgU7A287NDrwF2QvrqJ_RWgAeSuhmdAG0Jk2SgNsgStyo_m2kgU5Rll0d5lfo0PG63QD9KAb9KD7lx4U5ANKskO7BHFZPRwvgCYgw1U3l-AvAxjmvCAHk5pgT3ZaPOpCN9hz36FjBb48F6og77bF-CTGqEW_2mAdCfAbEHNVkJdZdbZd4gpwYcWbgqiJUk36PC2Jy--J7RsWI4mo8_X_GKU35FEFqCzHuh2QvfX9xr8FVLU2h8mA_gAcUCeN priority: 102 providerName: Directory of Open Access Journals – databaseName: Coronavirus Research Database dbid: COVID link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwEB7BVkJceD8CBRkJiVPaJPbmwQVtF6qCVFpRinqL_CyromTZZA_0D_E3mUmcpQGJA6eVYidrJ5_H39jjbwBemthGXExNqOMoD0Ws4lAWpI3HhSuk4opP6TTy4cf04FR8OJue-QW3xodVDjaxM9Sm1rRGvkvUFr0pLvI3y-8hZY2i3VWfQuM6bPEcPZ0JbM2Pvrx_u1lliTjOj2nWa_pw9O93Nb3MVYNEh8TNBqn-vw3ylRlpHC15ZfrZvw3l0PA-6uRiZ92qHX35h6bj__fsDtzyzJTNeijdhWu2ugc3Dv3e-3342QkJd9FF1TnrDu72yXoQwezTorlgs43KJ6PlXXZcf_uB-FzovviEFDMbhiyZHQ8uwKU1bI_i4ls2714Z1qJIIPqLRcWQneJThhRj7MR2Udqv2XxIAdMwWRl2tCQvYl116rAP4HT_3ef5QejTPIQG2VEbKmuKeGoVbQoLl-o4cUlukhTRJV2WFSayEkmIdcomaJ_QAVKUxkFH6Ne7VDr-ECZVXdnHwBwiKxcyFlIhD5Qql0iQ8JdU2GyRZAHs0dcul72SR0na2t2FenVe-qFa5jLNbVxo_ChOyEIryXWauMwKgyBQIoBXhJWSLAACQkt_kAGbQFpa5SxDzxxpN-cBbI9q4sjV4-IBEKW3HE35Gw0BvNgU050UDVfZek11MiT6yM2TAB714Nx0iefIQBOeBpCPYDvq87ikWnztdMVx2suI3z75d7uews0EmV0fL7cNk3a1ts-QmbXquR9-vwDto0G3 priority: 102 providerName: ProQuest – databaseName: Scholars Portal Open Access Journals dbid: M48 link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV3va9QwGA46Qfwy_G3nJhEEP1XbJJemgozb4RjC6XAe7FtJ0mQeG7ntegfOf8h_0_dN23PF4adCk_5I3ifJ87ZvnpeQN3XuMi5GdWrzTKUiN3mqS9TG48KX2nDDR7gbefpFHs3E59PR6d90QF0HNre6dphPara8ePfz6nofBvxH9DjBZX9vsX-WDXAX1CuTd8k9JrhAuE87rh-nZQ5LZcwoy7KCpVKWopX6ue0enYL_v_P0jYVqGER5Y1U6fEi2OzpJx639H5E7Ljwm96fdD_Mn5HdU_40hQeGMxt22bYYdgB39Nm_O6XgjzUnxmyw9XlxcA6jmti0-QZnLhgK1pcc9b__lanqAwewrOokNgloYvoOPmAcKlBLu0ucFoycuhlZ_oJM-b0tDdajp10vs9XWIkq5Pyezw0_fJUdrlZkhroDSr1Li6zEfO4J9c4aXNmWeqZhIgoX1RlHXmNDAH541jMKmA12Iw94LNwBn3Unv-jGyFRXAvCPUAByV0LrQB8qaN0sBq4IjSaa5kRUIO0BbVZSu_UaEgdjyxWJ5V3fiqlJbK5aUtuPJCl9ZobiXzhRM1mMiIhLxFS1YIJDCX1d3uA3gFFMCqxgW408CVOU_I7qAmDDc7LO6xUPVordDvAlefC5WQ15tivBJD2IJbrLFOAewcCDVLyPMWOpsmcQW0kXGZEDUA1aDNw5Iw_xHFwGGtKpCU7vz_tV-SBwzoWBvktku2Vsu12wM6tTKv4jD5Aww5Itw priority: 102 providerName: Scholars Portal |
| Title | Implementing Multifactorial Risk Assessment with Polygenic Risk Scores for Personalized Breast Cancer Screening in the Population Setting: Challenges and Opportunities |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/38893236 https://www.proquest.com/docview/3067383348 https://www.proquest.com/docview/3070801922/abstract/ https://pubmed.ncbi.nlm.nih.gov/PMC11171515 https://doaj.org/article/8a68e19c738f4a9cba3c62f7e4dedcb4 |
| Volume | 16 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3Pb9MwFLa2ISEuaPxc2KiMhMQpaxO7scOtDRsDqVu1MdRbZDv2qNjSqmkP8A_xb_Kek1SNuHFJpNpp47737O8ln79HyPsisgPGh0VoooEMeaSjUKWojce4S5Vmmg1xN_LkMrm45V9nw9keSdq9MJ60b_T8tLx_OC3nPzy3cvlg-i1PrD-dZBCfAhfi_j7ZF4zt5Oh-_mWwJiai1vFhkNP3Df6BqwrADQqaYdUiJmGdjlmr1P_vfLyzIHXJkjurz_khedrARjqqb-8Z2bPlc_J40rwYf0H-eJVfT_0p76jfVVtX0gH3otfz6icdbSU4KT57pdPF_S9wnrmpm29QzrKiAGHptMXnv21Bx0haX9PMjw16IU0Hf2JeUoCO8C1t_S96Yz2F-iPN2vosFVVlQa-WCPE3pZdufUluz8--ZRdhU4MhLAC6rENtizQaWo1vbLlLTBS7WBZxAqZXToi0GFgFCME6bWOYPCA70VhjwQwg6XaJcuwVOSgXpT0i1IHZJVcRVxpAmtJSAXqBM0qk2TQWARmjLfJlLbORo_C1_2Cxussb8-dSJdJGqRFMOq5SoxUzSeyE5QWYSPOAfEBL5hieYC6jml0GcAsodJWPBKTNgIkZC8hJpyeElek2t76QN2Fd5ZhfQUrPuAzIu20zXolUtdIuNthHAAoH4BwH5HXtOtshtW4XENlxqs6Yuy0QA170u_X5N_9_6TF5EgMkq4luJ-RgvdrYtwCp1rpHHo3PLqfXcM6uvn_51POPJuD4eRbBccJlz8fYX-e2LJw |
| link.rule.ids | 230,315,733,786,790,870,891,2115,21416,24346,27955,27956,33777,33778,38549,43838,43928,53825,53827,74657,74767 |
| linkProvider | National Library of Medicine |
| linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwEB7BVgIuvB-BAkZC4pQ2ib15cEHbhWoL3baiLerN8itlVZRdNtkD_UP8TWbyWBqQOHBaKXaydvJ5_I09_gbgtQ1dwMXQ-iYMUl-EOvRVRtp4XOSZ0lzzIZ1Gnh7Ek1Px8Wx41i64lW1YZWcTa0Nt54bWyLeJ2qI3xUX6bvHdp6xRtLvaptC4Dhs4sUbpADbGh1_23q9XWQKO82OcNJo-HP37bUMvc1ki0SFxs06q_2-DfGVG6kdLXpl-du-A7BreRJ1cbK0qvWUu_9B0_P-e3YXbLTNlowZK9-CaK-7DjWm79_4AftZCwnV0UXHO6oO7TbIeRDD7PCsv2Git8sloeZcdzb_9QHzOTFN8TIqZJUOWzI46F-DSWbZDcfEVG9evDGtRJBD9xaxgyE7xKV2KMXbs6ijtt2zcpYApmSosO1yQF7EqanXYh3C6--FkPPHbNA--RXZU-drZLBw6TZvCIo9NGOVRaqMY0aXyJMls4BSSEJdrF6F9QgdIUxoHE6Bfn8cq549gUMwL9wRYjshKhQqF0sgDlU4VEiT8JRU2l0WJBzv0teWiUfKQpK1dX5gvz2U7VGWq4tSFmcGPkguVGa24iaM8ccIiCLTw4A1hRZIFQEAY1R5kwCaQlpYcJeiZI-3m3IPNXk0cuaZf3AFCtpajlL_R4MGrdTHdSdFwhZuvqE6CRB-5eeTB4wac6y7xFBloxGMP0h5se33ulxSzr7WuOE57CfHbp_9u10u4OTmZ7sv9vYNPz-BWhCyviZ3bhEG1XLnnyNIq_aIdir8AFyBEng |
| linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1db9MwFLVgkyZe-GYEBhgJiaesSezmgxfUdVQbsK1iDO0t8udWdUpKkz6wP8Tf5N7EKQtIPPFUqXbaODm2z7WPzyXkjQ5NwPhQ-yoMUp-HMvRFht54jNtMSCbZEE8jHx3HB2f84_nw3OmfKier7MbEZqDWpcI18gFSW4imGE8H1skipvuT94vvPmaQwp1Wl07jNtkEihxDILY5Pvl2uL9ecQkYzJVx0vr7MIj1Bwof7LIC0oNGZ51t_9-D843Zqa-cvDEVTe6RedeIVoEy313Vcldd_-Hv-H9aeZ_cdYyVjlqIPSC3TPGQbB25PflH5GdjMNyojooL2hzobZP4ALLpl1k1p6O1-yfFZV86La9-AG5nqi0-RSfNigJ7ptMuNLg2mu6hXr6m4-bxQS1UCOFfzAoKrBV-pUs9Rk9No95-R8ddapiKikLTkwVGF6uicY19TM4mH76OD3yX_sHXwJpqXxqdhUMjcbOY21iFkY1SHcWAOmGTJNOBEUBOjJUmgnELAiOJ6R1UAPG-jYVlT8hGURbmKaEWEJdyEXIhgR8KmQogTvCJ7mwmixKP7OGbzxetw0eOntvNF-XyInddOE9FnJowU_CCLBeZkoKpOLKJ4RoAIblH3iJuchwZABxKuAMOcAvosZWPEojYgY4z5pGdXk3o0apf3IEjdyNKlf9Ghkder4vxSlTJFaZcYZ0EAgDg7JFHtlugrpvEUmCmEYs9kvYg3Gtzv6SYXTZ-4zAdJsh7n_37vl6RLcBq_vnw-NNzcicC8tdK6nbIRr1cmRdA3mr50vXKX2lwTWE |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Implementing+Multifactorial+Risk+Assessment+with+Polygenic+Risk+Scores+for+Personalized+Breast+Cancer+Screening+in+the+Population+Setting%3A+Challenges+and+Opportunities&rft.jtitle=Cancers&rft.au=Walker%2C+Meghan+J&rft.au=Blackmore%2C+Kristina+M&rft.au=Chang%2C+Amy&rft.au=Lambert-C%C3%B4t%C3%A9%2C+Laurence&rft.date=2024-06-01&rft.pub=MDPI+AG&rft.issn=2072-6694&rft.eissn=2072-6694&rft.volume=16&rft.issue=11&rft_id=info:doi/10.3390%2Fcancers16112116&rft.externalDocID=A797899133 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2072-6694&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2072-6694&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2072-6694&client=summon |