February 22, 2024

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The breast cancer screening for low-risk women can be delayed by 5-10 years!

The breast cancer screening for low-risk women can be delayed by 5-10 years!



The breast cancer screening for low-risk women can be delayed by 5-10 years!

With consistent health education efforts, the awareness of cancer prevention and early detection among young people has significantly increased. Effective cancer screening strategies, such as painless gastroscopy and mammography, are in high demand in many places, leading to long waiting lists for appointments. This trend is commendable.

However, a one-size-fits-all approach to screening is not optimal, considering individual differences, especially in genetic risks. The recent brief research published in JAMA Oncology indicates that women with a low genetic risk for breast cancer can safely delay mammography by 5-10 years compared to the general population.

Many epidemiological studies show that women enter the first peak period of breast cancer incidence around the age of 40, 10-20 years earlier than in Western countries.

Therefore, guidelines recommend starting breast cancer screening earlier, especially for high-risk individuals, beginning at the age of 25. However, there is no clear recommendation for the starting time of screening for low-risk individuals.

The study, based on electronic health records from Nevada, included a retrospective case-control analysis of over 25,000 women. Those defined as low-risk for breast cancer met two criteria: 1) did not carry pathogenic or uncertain variants of BRCA1/2, PALB2, ATM, and CHEK2 genes, and 2) ranked in the lowest 10% of the population in breast cancer polygenic risk score (PRS) assessed by 313 specific single nucleotide variations (SNVs).

The breast cancer screening for low-risk women can be delayed by 5-10 years!

 

 

 

According to these criteria, approximately 9.1% (2338 individuals) of the study population were classified as low-risk for breast cancer, with 1.6% considered high-risk, and the remaining nearly 90% as average risk. The low-risk group had a 61% lower breast cancer risk during the entire follow-up period compared to the average-risk group (HR=0.39).

The researchers then tracked self-recommended screening starting ages and mammography results every two years from the age of 40. The data showed that from 40 to 45 years old, the average-risk group’s cumulative incidence rate of breast cancer was 0.69%, while the low-risk group only reached this level at the age of 51.

Similarly, from 40 to 50 years old, the cumulative incidence rate for the average-risk group was 1.41%, equivalent to the low-risk group’s rate at 58 years old. Therefore, delaying the start of mammography screening by 5-10 years for low-risk individuals seems feasible, potentially saving millions of unnecessary screenings each year.

 

The breast cancer screening for low-risk women can be delayed by 5-10 years!


Reference:
[1] Bolze A, Cirulli E T, Hajek C, et al. The Potential of Genetics in Identifying Women at Lower Risk of Breast Cancer [J]. JAMA Oncology, 2023.

 

(source:internet, reference only)

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