New Model Will Help Health Care Providers More Accurately Assess Breast Cancer Risk in Hispanic Patients
The Hispanic Risk Model is the first breast cancer model based exclusively on data from Hispanic women. It was developed by a Kaiser Permanente researcher and his colleagues and is published today in the Journal of the National Cancer Institute.
The Hispanic Risk Model will be incorporated into the National Cancer Institute’s Breast Cancer Risk Assessment Tool, which is used by health care providers to assess breast cancer risk in individual patients. The tool currently underestimates risk in Hispanic women because it contains no model specific to them.
“Hispanics are the largest racial/ethnic minority group in the U.S., so it’s important that the NCI tool include information from these women in determining their risk score. Our model does that because it is based on data from Hispanic women and tailored specifically for them,” said Matthew P. Banegas, PhD, MPH, lead author and researcher from the Kaiser Permanente Center for Health Research.
Farming and health research both require meticulous recordkeeping, a skill Matthew Banegas learned from his grandfather, who had a farm in rural New Mexico. Banegas now studies disparities in cancer care with the goal of better understanding and reducing those disparities.
“Prior studies have shown that Hispanic women born in the U.S. have a higher breast cancer risk than Hispanic women who emigrate here from other countries,” said Banegas. “Our model includes data from U.S. and foreign-born women, so providers will be able to more accurately predict risk based on where the woman was born.”
Other factors taken into account in the Hispanic Risk Model include:
- When the patient started her first menstrual period
- Her age at first full-term pregnancy
- Whether she has first-degree relatives with breast cancer
- Whether she has had a breast biopsy for benign breast disease
These risk factors are already incorporated into the NCI’s Breast Cancer Risk Assessment Tool for non-Hispanic white, African-American and Asian and Pacific Islander women.
Building and validating the Hispanic Risk Model
To build the model, researchers started with data from the San Francisco Bay Area Breast Cancer Study, which included 1,086 Hispanic women who developed breast cancer between 1995 and 2002 and 1,411 women who did not have breast cancer. Nearly 1,000 of the women were born in the United States and 1,500 were born in other countries. The researchers then included breast cancer incidence and mortality data from the California Cancer Registry and NCI’s Surveillance, Epidemiology and End Results program.
To validate their model, researchers used data from the Women’s Health Initiative and the Four-Corners Breast Cancer Study. The new model accurately predicted the number of breast cancers among U.S.-born Hispanic women who participated in the Women’s Health Initiative, but slightly overestimated the number of breast cancers among foreign-born Hispanic women in the WHI.
“We built the model using data from Hispanic women in California who are mostly of Mexican and Central American descent, so these are the women for whom the model will be most accurate,” said Banegas. “As we collect more data on Hispanic women from other regions and countries, we will be able to further refine the model.”
The new model, like the National Cancer Institute’s Breast Cancer Risk Assessment Tool, should not be used for women who already have invasive breast cancer, for women who have an inherited genetic mutation known to cause breast cancer, or for women who received therapeutic radiation of the chest for other types of cancers.
This study was supported by the Intramural Research Program of the National Cancer Institute, National Institutes of Health.
Other authors include: Esther M. John PhD, MSPH, and Scarlett Lin Gomez, PhD, MPH, Cancer Prevention Institute of California and the Department of Health Research and Policy at the Stanford Cancer Institute; Martha L. Slattery, PhD, MPH, University of Utah Department of Medicine; Mandi Yu, PhD, Division of Cancer Control and Population Sciences, National Cancer Institute; Andrea LaCroix, PhD, Family and Preventive Medicine, University of California, San Diego; David Pee, MPhil, Information Management Services; Rowan T. Chlebowski, MD, PhD, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center; Lisa Hines, ScD, Department of Biology, University of Colorado Colorado Springs; Cynthia Thompson, PhD, RD, Mel and Enid Zuckerman College of Public Health, University of Arizona; and Mitchell Gail, MD, PhD, Division of Cancer Epidemiology and Genetics, National Cancer Institute.