Risk-stratified screening
Research type
Research Study
Full title
Risk-stratified screening for breast cancer: modelling natural history and screening strategies
IRAS ID
232381
Contact name
Nora /N. Pashayan
Contact email
Sponsor organisation
UCL
Clinicaltrials.gov Identifier
2017NovPR1024, Breast Cancer Now (funder's) reference
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
The risk of developing breast cancer varies from woman to woman. This proposal will examine whether a breast screening programme that personalises or tailors screening timing and frequency according to women’s risk level does more good than harm at an affordable cost to the NHS.
This proposal will be based on anonymised data from the Studies of Epidemiology and Risk Factors in Cancer Heredity (SEARCH), a population-based case control study. The cases are women (N=15,484) younger than 70 years of age diagnosed with breast cancer from 1996-2013 in East Anglia. The controls are women (N=1,922) without breast cancer living in East Anglia.
• The SEARCH team will estimate 10-year absolute risk of developing breast cancer for each participant, using information on breast cancer susceptibility genetic variants and epidemiological risk factors.
• SEARCH has cancer registry data with information on breast cancer histology, stage, date of diagnosis, and vital status.
• SEARCH data will be linked to NHS Breast Screening Programme on date and outcome of each breast screening attendance of SEARCH participants from 1998-2018. CAG approval is being sought to link SEARCH data to screening data.
• The SEARCH team will process the data to de-personalise it and provide the UCL team the anonymised dataset with pre-specified selected variables.
At UCL, using mathematical models (continuous-time multistate Markov model), we will examine how the natural course of breast cancer and sensitivity of the mammogram vary by risk level. In decision-analytical model, we will evaluate different screening strategies, which vary by screening age, frequency, and modality, for the extent of reducing breast cancer deaths and overdiagnosis (diagnosis of tumour by screening that otherwise would not have presented clinically during a woman’s lifetime) and for their value for money.
This will guide evidence-based recommendations on risk-tailored screening strategies for breast cancer.REC name
London - Bloomsbury Research Ethics Committee
REC reference
19/LO/1765
Date of REC Opinion
22 Nov 2019
REC opinion
Favourable Opinion