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. 2021 Oct 15;127(20):3742-3750.
doi: 10.1002/cncr.33767. Epub 2021 Jul 6.

Performance of the IBIS/Tyrer-Cuzick model of breast cancer risk by race and ethnicity in the Women's Health Initiative

Allison W Kurian  1   2 , Elisha Hughes  3 , Timothy Simmons  3 , Ryan Bernhisel  3 , Braden Probst  3 , Stephanie Meek  3 , Jennifer L Caswell-Jin  1 , Esther M John  2 , Jerry S Lanchbury  3 , Thomas P Slavin  3 , Susanne Wagner  3 , Alexander Gutin  3 , Thomas E Rohan  4 , Aladdin H Shadyab  5 , JoAnn E Manson  6 , Dorothy Lane  7 , Rowan T Chlebowski  8 , Marcia L Stefanick  1
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Free article

Performance of the IBIS/Tyrer-Cuzick model of breast cancer risk by race and ethnicity in the Women's Health Initiative

Allison W Kurian et al. Cancer. .
Free article

Abstract

Background: The IBIS/Tyrer-Cuzick model is used clinically to guide breast cancer screening and prevention, but was developed primarily in non-Hispanic White women. Little is known about its long-term performance in a racially/ethnically diverse population.

Methods: The Women's Health Initiative study enrolled postmenopausal women from 1993-1998. Women were included who were aged <80 years at enrollment with no prior breast cancer or mastectomy and with data required for IBIS/Tyrer-Cuzick calculation (weight; height; ages at menarche, first birth, and menopause; menopausal hormone therapy use; and family history of breast or ovarian cancer). Calibration was assessed by the ratio of observed breast cancer cases to the number expected by the IBIS/Tyrer-Cuzick model (O/E; calculated as the sum of cumulative hazards). Differential discrimination was tested for by self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, Asian or Pacific Islander, and American Indian or Alaskan Native) using Cox regression. Exploratory analyses, including simulation of a protective single-nucleotide polymorphism (SNP), rs140068132 at 6q25, were performed.

Results: During follow-up (median 18.9 years, maximum 23.4 years), 6783 breast cancer cases occurred among 90,967 women. IBIS/Tyrer-Cuzick was well calibrated overall (O/E ratio = 0.95; 95% CI, 0.93-0.97) and in most racial/ethnic groups, but overestimated risk for Hispanic women (O/E ratio = 0.75; 95% CI, 0.62-0.90). Discrimination did not differ by race/ethnicity. Exploratory simulation of the protective SNP suggested improved IBIS/Tyrer-Cuzick calibration for Hispanic women (O/E ratio = 0.80; 95% CI, 0.66-0.96).

Conclusions: The IBIS/Tyrer-Cuzick model is well calibrated for several racial/ethnic groups over 2 decades of follow-up. Studies that incorporate genetic and other risk factors, particularly among Hispanic women, are essential to improve breast cancer-risk prediction.

Keywords: IBIS/Tyrer-Cuzick; breast cancer; breast cancer risk; model performance; race/ethnicity.

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References

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