Projecting Individualized Absolute Invasive Breast Cancer Risk in US Hispanic Women
Open accessAbstract
Background: There is no model to estimate absolute invasive breast cancer risk for Hispanic women. Methods: The San Francisco Bay Area Breast Cancer Study (SFBCS) provided data on Hispanic breast cancer case patients (533 US-born, 553 foreign-born) and control participants (464 US-born, 947 foreign-born). These data yielded estimates of relative risk (RR) and attributable risk (AR) separately for US-born and foreign-born women. Nativity-specific absolute risks were estimated by combining RR and AR information with nativity-specific invasive breast cancer incidence and competing mortality rates from the California Cancer Registry and Surveillance, Epidemiology, and End Results program to develop the Hispanic risk model (HRM). In independent data, we assessed model calibration through observed/expected (O/E) ratios, and we estimated discriminatory accuracy with the area under the receiver operating characteristic curve (AUC) statistic. Results: The US-born HRM included age at first full-term pregnancy, biopsy for benign breast disease, and family history of breast cancer; the foreign-born HRM also included age at menarche. The HRM estimated lower risks than the National Cancer Institute's Breast Cancer Risk Assessment Tool (BCRAT) for US-born Hispanic women, but higher risks in foreign-born women. In independent data from the Women's Health Initiative, the HRM was well calibrated for US-born women (observed/expected [O/E] ratio = 1.07, 95% confidence interval [CI] = 0.81 to 1.40), but seemed to overestimate risk in foreign-born women (O/E ratio = 0.66, 95% CI = 0.41 to 1.07). The AUC was 0.564 (95% CI = 0.485 to 0.644) for US-born and 0.625 (95% CI = 0.487 to 0.764) for foreign-born women. Conclusions: The HRM is the first absolute risk model that is based entirely on data specific to Hispanic women by nativity. Further studies in Hispanic women are warranted to evaluate its validity.
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- Authors
- Banegas, M. P., John, E. M., Slattery, M. L., Gomez, S. L., Yu, M., LaCroix, A. Z., Pee, D., Chlebowski, R. T., Hines, L. M., Thompson, C. A., & Gail, M. H.
- Affiliations
- National Institutes of Health (US)
- ORCID
- Venue
- Journal of the National Cancer Institute
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-12-20
- Volume
- 109
- Issue
- 2
- Pages
- djw215
- ISSN
- 0027-8874 (ISSN-L)
- 1460-2105
- PMC
- PMC5174188
- OpenAlex
- W2565784393
- Cited by
- 74
- References
- 30
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 13 · 2023: 10 · 2022: 9 · 2021: 7 · 2020: 13 · 2019: 6 · 2018: 5 · 2017: 1 · 2016: 1
- FWCI
- 2.33
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- public-domain
- Locations
- JNCI Journal of the National Cancer Institute (publishedVersion, public-domain)
- Europe PMC (PubMed Central) (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- U.S. Department of Defense (7PB-0068, DAMD17-96-1-6071)
- California Breast Cancer Research Program (7PB-0068)
- National Institutes of Health
- National Cancer Institute (R01CA063446, CA63446, CA 078762, R01CA077305, CA078552, R01CA078682, R01CA078802, CA078802, R01CA078762, R01CA078552, CA14002, CA078682, CA078762, CA078552, and CA078802, CA77305, CA 078682)
- National Institute on Minority Health and Health Disparities
- Division of Cancer Epidemiology and Genetics, National Cancer Institute (CA14002)
- Topics
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
- Keywords
- invasive breast cancer risk, Hispanic women, nativity, foreign-born women, age at first full-term pregnancy, family history of breast cancer, age at menarche, Breast Cancer Risk Assessment Tool, risk model calibration, discriminatory accuracy
- MeSH terms
- Adult, Aged, Breast Neoplasms, Female, Hispanic or Latino, Humans, Longitudinal Studies, Middle Aged, Risk Factors, ROC Curve, United States, Incidence, Logistic Models, Case-Control Studies, Women's Health, Carcinoma, Ductal, Breast, Risk Assessment, Area Under Curve
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