Risk stratification in breast screening workshop

Area of Science:

• Oncology
• Public Health
• Biostatistics

Background:

• Current UK breast cancer (BC) screening targets women aged 50-71 to reduce mortality.
• High-risk women receive additional screening within the national program.
• Growing interest exists in personalizing screening through risk stratification.

Purpose of the Study:

• To evaluate risk stratification screening strategies for breast cancer.
• To inform the UK National Screening Committee (UK NSC) on potential benefits and harms.
• To identify evidence gaps for implementing risk-tailored screening.

Main Methods:

• Proceedings of a UK NSC workshop discussing risk prediction and decision-analytic models.
• Expert discussions on benefit-harm analysis and economic evaluations of risk-stratified programs.
• Review of current expert work and preliminary data.

Main Results:

• Experts discussed risk prediction and decision-analytic models for BC screening.
• Identified areas for further work include model comparison, risk assessment tools, digital infrastructure, acceptability, screening test choice, and reducing inequalities.
• A phased introduction with real-world evidence assessment is suggested for program-wide stratification.

Conclusions:

• Risk stratification offers a potential improvement over age-based breast cancer screening.
• Further research and careful planning are essential for successful implementation.
• Addressing identified gaps is crucial for developing effective, equitable risk-tailored screening programs.