Performance of the IBIS/Tyrer-Cuzick model of breast cancer risk by race and ethnicity in the Women's Health Initiative

Allison W. Kurian; Elisha Hughes; Timothy Simmons; Ryan Bernhisel; Braden Probst; Stephanie Meek; Jennifer L. Caswell-Jin; Esther M. John; Jerry S. Lanchbury; Thomas P. Slavin; Susanne Wagner; Alexander Gutin; Thomas E. Rohan; Aladdin H. Shadyab; Jo Ann E. Manson; Dorothy Lane; Rowan T. Chlebowski; Marcia L. Stefanick

doi:10.1002/cncr.33767

Performance of the IBIS/Tyrer-Cuzick model of breast cancer risk by race and ethnicity in the Women's Health Initiative

Allison W. Kurian, Elisha Hughes, Timothy Simmons, Ryan Bernhisel, Braden Probst, Stephanie Meek, Jennifer L. Caswell-Jin, Esther M. John, Jerry S. Lanchbury, Thomas P. Slavin, Susanne Wagner, Alexander Gutin, Thomas E. Rohan, Aladdin H. Shadyab, Jo Ann E. Manson, Dorothy Lane, Rowan T. Chlebowski, Marcia L. Stefanick

Epidemiology & Population Health

Research output: Contribution to journal › Article › peer-review

19 Scopus citations

Abstract

BACKGROUND: The IBIS/Tyrer-Cuzick model is used clinically to guide breast cancer screening and prevention, but was developed primarily in non-Hispanic White women. Little is known about its long-term performance in a racially/ethnically diverse population. METHODS: The Women's Health Initiative study enrolled postmenopausal women from 1993-1998. Women were included who were aged <80 years at enrollment with no prior breast cancer or mastectomy and with data required for IBIS/Tyrer-Cuzick calculation (weight; height; ages at menarche, first birth, and menopause; menopausal hormone therapy use; and family history of breast or ovarian cancer). Calibration was assessed by the ratio of observed breast cancer cases to the number expected by the IBIS/Tyrer-Cuzick model (O/E; calculated as the sum of cumulative hazards). Differential discrimination was tested for by self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, Asian or Pacific Islander, and American Indian or Alaskan Native) using Cox regression. Exploratory analyses, including simulation of a protective single-nucleotide polymorphism (SNP), rs140068132 at 6q25, were performed. RESULTS: During follow-up (median 18.9 years, maximum 23.4 years), 6783 breast cancer cases occurred among 90,967 women. IBIS/Tyrer-Cuzick was well calibrated overall (O/E ratio = 0.95; 95% CI, 0.93-0.97) and in most racial/ethnic groups, but overestimated risk for Hispanic women (O/E ratio = 0.75; 95% CI, 0.62-0.90). Discrimination did not differ by race/ethnicity. Exploratory simulation of the protective SNP suggested improved IBIS/Tyrer-Cuzick calibration for Hispanic women (O/E ratio = 0.80; 95% CI, 0.66-0.96). CONCLUSIONS: The IBIS/Tyrer-Cuzick model is well calibrated for several racial/ethnic groups over 2 decades of follow-up. Studies that incorporate genetic and other risk factors, particularly among Hispanic women, are essential to improve breast cancer–risk prediction.

Original language	English (US)
Pages (from-to)	3742-3750
Number of pages	9
Journal	Cancer
Volume	127
Issue number	20
DOIs	https://doi.org/10.1002/cncr.33767
State	Published - Oct 15 2021

Keywords

IBIS/Tyrer-Cuzick
breast cancer
breast cancer risk
model performance
race/ethnicity

ASJC Scopus subject areas

Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/cncr.33767

Cite this

Kurian, A. W., Hughes, E., Simmons, T., Bernhisel, R., Probst, B., Meek, S., Caswell-Jin, J. L., John, E. M., Lanchbury, J. S., Slavin, T. P., Wagner, S., Gutin, A., Rohan, T. E., Shadyab, A. H., Manson, J. A. E., Lane, D., Chlebowski, R. T., & Stefanick, M. L. (2021). Performance of the IBIS/Tyrer-Cuzick model of breast cancer risk by race and ethnicity in the Women's Health Initiative. Cancer, 127(20), 3742-3750. https://doi.org/10.1002/cncr.33767

Kurian, AW, Hughes, E, Simmons, T, Bernhisel, R, Probst, B, Meek, S, Caswell-Jin, JL, John, EM, Lanchbury, JS, Slavin, TP, Wagner, S, Gutin, A, Rohan, TE, Shadyab, AH, Manson, JAE, Lane, D, Chlebowski, RT & Stefanick, ML 2021, 'Performance of the IBIS/Tyrer-Cuzick model of breast cancer risk by race and ethnicity in the Women's Health Initiative', Cancer, vol. 127, no. 20, pp. 3742-3750. https://doi.org/10.1002/cncr.33767

@article{d0103b14d82647aa94e5ab06031f1dc6,

title = "Performance of the IBIS/Tyrer-Cuzick model of breast cancer risk by race and ethnicity in the Women's Health Initiative",

abstract = "BACKGROUND: The IBIS/Tyrer-Cuzick model is used clinically to guide breast cancer screening and prevention, but was developed primarily in non-Hispanic White women. Little is known about its long-term performance in a racially/ethnically diverse population. METHODS: The Women's Health Initiative study enrolled postmenopausal women from 1993-1998. Women were included who were aged <80 years at enrollment with no prior breast cancer or mastectomy and with data required for IBIS/Tyrer-Cuzick calculation (weight; height; ages at menarche, first birth, and menopause; menopausal hormone therapy use; and family history of breast or ovarian cancer). Calibration was assessed by the ratio of observed breast cancer cases to the number expected by the IBIS/Tyrer-Cuzick model (O/E; calculated as the sum of cumulative hazards). Differential discrimination was tested for by self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, Asian or Pacific Islander, and American Indian or Alaskan Native) using Cox regression. Exploratory analyses, including simulation of a protective single-nucleotide polymorphism (SNP), rs140068132 at 6q25, were performed. RESULTS: During follow-up (median 18.9 years, maximum 23.4 years), 6783 breast cancer cases occurred among 90,967 women. IBIS/Tyrer-Cuzick was well calibrated overall (O/E ratio = 0.95; 95% CI, 0.93-0.97) and in most racial/ethnic groups, but overestimated risk for Hispanic women (O/E ratio = 0.75; 95% CI, 0.62-0.90). Discrimination did not differ by race/ethnicity. Exploratory simulation of the protective SNP suggested improved IBIS/Tyrer-Cuzick calibration for Hispanic women (O/E ratio = 0.80; 95% CI, 0.66-0.96). CONCLUSIONS: The IBIS/Tyrer-Cuzick model is well calibrated for several racial/ethnic groups over 2 decades of follow-up. Studies that incorporate genetic and other risk factors, particularly among Hispanic women, are essential to improve breast cancer–risk prediction.",

keywords = "IBIS/Tyrer-Cuzick, breast cancer, breast cancer risk, model performance, race/ethnicity",

author = "Kurian, {Allison W.} and Elisha Hughes and Timothy Simmons and Ryan Bernhisel and Braden Probst and Stephanie Meek and Caswell-Jin, {Jennifer L.} and John, {Esther M.} and Lanchbury, {Jerry S.} and Slavin, {Thomas P.} and Susanne Wagner and Alexander Gutin and Rohan, {Thomas E.} and Shadyab, {Aladdin H.} and Manson, {Jo Ann E.} and Dorothy Lane and Chlebowski, {Rowan T.} and Stefanick, {Marcia L.}",

note = "Publisher Copyright: {\textcopyright} 2021 American Cancer Society",

year = "2021",

month = oct,

day = "15",

doi = "10.1002/cncr.33767",

language = "English (US)",

volume = "127",

pages = "3742--3750",

journal = "Cancer",

issn = "0008-543X",

publisher = "John Wiley and Sons Inc.",

number = "20",

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TY - JOUR

T1 - Performance of the IBIS/Tyrer-Cuzick model of breast cancer risk by race and ethnicity in the Women's Health Initiative

AU - Kurian, Allison W.

AU - Hughes, Elisha

AU - Simmons, Timothy

AU - Bernhisel, Ryan

AU - Probst, Braden

AU - Meek, Stephanie

AU - Caswell-Jin, Jennifer L.

AU - John, Esther M.

AU - Lanchbury, Jerry S.

AU - Slavin, Thomas P.

AU - Wagner, Susanne

AU - Gutin, Alexander

AU - Rohan, Thomas E.

AU - Shadyab, Aladdin H.

AU - Manson, Jo Ann E.

AU - Lane, Dorothy

AU - Chlebowski, Rowan T.

AU - Stefanick, Marcia L.

PY - 2021/10/15

Y1 - 2021/10/15

N2 - BACKGROUND: The IBIS/Tyrer-Cuzick model is used clinically to guide breast cancer screening and prevention, but was developed primarily in non-Hispanic White women. Little is known about its long-term performance in a racially/ethnically diverse population. METHODS: The Women's Health Initiative study enrolled postmenopausal women from 1993-1998. Women were included who were aged <80 years at enrollment with no prior breast cancer or mastectomy and with data required for IBIS/Tyrer-Cuzick calculation (weight; height; ages at menarche, first birth, and menopause; menopausal hormone therapy use; and family history of breast or ovarian cancer). Calibration was assessed by the ratio of observed breast cancer cases to the number expected by the IBIS/Tyrer-Cuzick model (O/E; calculated as the sum of cumulative hazards). Differential discrimination was tested for by self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, Asian or Pacific Islander, and American Indian or Alaskan Native) using Cox regression. Exploratory analyses, including simulation of a protective single-nucleotide polymorphism (SNP), rs140068132 at 6q25, were performed. RESULTS: During follow-up (median 18.9 years, maximum 23.4 years), 6783 breast cancer cases occurred among 90,967 women. IBIS/Tyrer-Cuzick was well calibrated overall (O/E ratio = 0.95; 95% CI, 0.93-0.97) and in most racial/ethnic groups, but overestimated risk for Hispanic women (O/E ratio = 0.75; 95% CI, 0.62-0.90). Discrimination did not differ by race/ethnicity. Exploratory simulation of the protective SNP suggested improved IBIS/Tyrer-Cuzick calibration for Hispanic women (O/E ratio = 0.80; 95% CI, 0.66-0.96). CONCLUSIONS: The IBIS/Tyrer-Cuzick model is well calibrated for several racial/ethnic groups over 2 decades of follow-up. Studies that incorporate genetic and other risk factors, particularly among Hispanic women, are essential to improve breast cancer–risk prediction.

AB - BACKGROUND: The IBIS/Tyrer-Cuzick model is used clinically to guide breast cancer screening and prevention, but was developed primarily in non-Hispanic White women. Little is known about its long-term performance in a racially/ethnically diverse population. METHODS: The Women's Health Initiative study enrolled postmenopausal women from 1993-1998. Women were included who were aged <80 years at enrollment with no prior breast cancer or mastectomy and with data required for IBIS/Tyrer-Cuzick calculation (weight; height; ages at menarche, first birth, and menopause; menopausal hormone therapy use; and family history of breast or ovarian cancer). Calibration was assessed by the ratio of observed breast cancer cases to the number expected by the IBIS/Tyrer-Cuzick model (O/E; calculated as the sum of cumulative hazards). Differential discrimination was tested for by self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, Asian or Pacific Islander, and American Indian or Alaskan Native) using Cox regression. Exploratory analyses, including simulation of a protective single-nucleotide polymorphism (SNP), rs140068132 at 6q25, were performed. RESULTS: During follow-up (median 18.9 years, maximum 23.4 years), 6783 breast cancer cases occurred among 90,967 women. IBIS/Tyrer-Cuzick was well calibrated overall (O/E ratio = 0.95; 95% CI, 0.93-0.97) and in most racial/ethnic groups, but overestimated risk for Hispanic women (O/E ratio = 0.75; 95% CI, 0.62-0.90). Discrimination did not differ by race/ethnicity. Exploratory simulation of the protective SNP suggested improved IBIS/Tyrer-Cuzick calibration for Hispanic women (O/E ratio = 0.80; 95% CI, 0.66-0.96). CONCLUSIONS: The IBIS/Tyrer-Cuzick model is well calibrated for several racial/ethnic groups over 2 decades of follow-up. Studies that incorporate genetic and other risk factors, particularly among Hispanic women, are essential to improve breast cancer–risk prediction.

KW - IBIS/Tyrer-Cuzick

KW - breast cancer

KW - breast cancer risk

KW - model performance

KW - race/ethnicity

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SP - 3742

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JO - Cancer

JF - Cancer

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ER -

Performance of the IBIS/Tyrer-Cuzick model of breast cancer risk by race and ethnicity in the Women's Health Initiative

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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