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Validating Breast Cancer Risk Prediction Models in the Korean Cancer Prevention Study-II Biobank

Authors
 Yon Ho Jee  ;  Chi Gao  ;  Jihye Kim  ;  Seho Park  ;  Sun Ha Jee  ;  Peter Kraft 
Citation
 CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, Vol.29(6) : 1271-1277, 2020-06 
Journal Title
 CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION 
ISSN
 1055-9965 
Issue Date
2020-06
Abstract
Background: Risk prediction models may be useful for precision breast cancer screening. We aimed to evaluate the performance of breast cancer risk models developed in European-ancestry studies in a Korean population. Methods: We compared discrimination and calibration of three multivariable risk models in a cohort of 77,457 women from the Korean Cancer Prevention Study (KCPS)-II. The first incorporated U.S. breast cancer incidence and mortality rates, U.S. risk factor distributions, and RR estimates from European-ancestry studies. The second recalibrated the first by using Korean incidence and mortality rates and Korean risk factor distributions, while retaining the European-ancestry RR estimates. Finally, we derived a Korea-specific model incorporating the RR estimates from KCPS. Results: The U.S. European-ancestry breast cancer risk model was well calibrated among Korean women <50 years [expected/observed = 1.124 (0.989, 1.278)] but markedly overestimated the risk for those ≥50 years [E/O = 2.472 (2.005, 3.049)]. Recalibrating absolute risk estimates using Korean breast cancer rates and risk distributions markedly improved the calibration in women ≥50 [E/O = 1.018 (0.825, 1.255)]. The model incorporating Korean-based RRs had similar but not clearly improved performance relative to the recalibrated model. Conclusions: The poor performance of the U.S. European-ancestry breast cancer risk model among older Korean women highlights the importance of tailoring absolute risk models to specific populations. Recalibrating the model using Korean incidence and mortality rates and risk factor distributions greatly improved performance. Impact: The data will provide valuable information to plan and evaluate actions against breast cancer focused on primary prevention and early detection in Korean women.
Full Text
https://cebp.aacrjournals.org/content/29/6/1271.long
DOI
10.1158/1055-9965.EPI-19-1478
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Park, Se Ho(박세호) ORCID logo https://orcid.org/0000-0001-8089-2755
Jee, Sun Ha(지선하) ORCID logo https://orcid.org/0000-0001-9519-3068
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/179452
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