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WISDOM Randomized Trial Comparing Risk-Based Versus Annual Breast Cancer Screening: Study Cohort Characteristics and

Allison Fiscalini1, Kelly Blum1, Kirkpatrick Fergus1

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Summary
This summary is machine-generated.

The Women Informed to Screen Depending on Measures of risk (WISDOM) Study found that most women prefer risk-based breast cancer screening. This pragmatic trial assessed personalized screening schedules, showing a strong patient preference for tailored approaches.

Keywords:
Breast CancerPolygenic Risk ScorePreventionRandomized Controlled TrialScreening

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Area of Science:

  • Oncology
  • Preventive Medicine
  • Clinical Trials

Background:

  • Breast cancer screening guidelines lack personalization.
  • Risk assessment models can inform tailored screening strategies.
  • The Women Informed to Screen Depending on Measures of risk (WISDOM) Study addresses this gap.

Purpose of the Study:

  • To evaluate a risk-based approach for determining breast cancer screening initiation age, frequency, and modality.
  • To assess participant preferences for different screening strategies within a pragmatic trial framework.
  • To compare risk-based screening with standard screening protocols.

Main Methods:

  • A pragmatic randomized controlled trial (NCT02620852) with a preference-tolerant design.
  • Inclusion of comprehensive breast cancer risk assessment using the Breast Cancer Surveillance Consortium (BCSC) model and genetic factors.
  • Enrollment of a diverse, nationwide cohort of 46,403 participants from August 2016 to February 2023.

Main Results:

  • 61% of participants (28,372) were randomized; 89% of those who self-selected their arm chose risk-based screening.
  • The study enrolled a large, diverse cohort with increasing demographic representation over time.
  • A strong participant preference for risk-based breast cancer screening was observed.

Conclusions:

  • A preference-tolerant design effectively captures real-world screening preferences while maintaining scientific rigor.
  • Risk-based breast cancer screening is strongly preferred by a majority of women.
  • Personalized screening strategies hold significant potential for improving adherence and outcomes.