Use of Breast Cancer Risk Factors to Identify Risk-Adapted Starting Age of Screening in China

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• Current breast cancer screening guidelines in China emphasize earlier detection for high-risk women, but lack specific data on risk-adapted starting ages.
• Limited data exists on tailoring breast cancer screening initiation based on individual risk profiles in the Chinese population.

Purpose of the Study:

• To determine the risk-adapted starting age for breast cancer screening in China.
• To comprehensively consider various breast cancer risk factors in establishing screening age recommendations.

Main Methods:

• A multicenter community-based cohort study was conducted involving 1,549,988 unscreened women aged 40-74 in China.
• Data on risk factors (family history, benign breast disease, BMI, etc.) were collected, and breast cancer diagnosis and age at diagnosis were tracked.
• Risk-adapted starting age was defined as the age when a woman's 10-year cumulative risk matched that of a 50-year-old in the general population.

Main Results:

• Breast cancer was diagnosed in 3,895 women during a median follow-up of 4.47 years.
• Optimal screening start ages were identified: 43 years for high-risk, 48 years for medium-risk, and after 55 years for low-risk women.
• An online calculator was developed to determine individual optimal screening start ages based on risk factors.

Conclusions:

• This study provides evidence-based, risk-adapted starting ages for breast cancer screening in China.
• The findings support updating current screening guidelines based on the principle of equal management for equal risks.
• Implementing risk-adapted screening can optimize resource allocation and improve early breast cancer detection rates.