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J Natl Cancer Inst. 2016 Dec 20;109(2). doi: 10.1093/jnci/djw215. Print 2017 Feb.

Projecting Individualized Absolute Invasive Breast Cancer Risk in US Hispanic Women.

Author information

Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA.
Cancer Prevention Institute of California, Fremont, CA, USA.
University of Utah, Department of Medicine, Salt Lake City, UT, USA.
Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
Division of Epidemiology, Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA.
Information Management Services, Rockville, MD, USA.
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.
Department of Biology, University of Colorado Colorado Springs, Colorado Springs, CO, USA.
Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.



There is no model to estimate absolute invasive breast cancer risk for Hispanic women.


The San Francisco Bay Area Breast Cancer Study (SFBCS) provided data on Hispanic breast cancer case patients (533 US-born, 553 foreign-born) and control participants (464 US-born, 947 foreign-born). These data yielded estimates of relative risk (RR) and attributable risk (AR) separately for US-born and foreign-born women. Nativity-specific absolute risks were estimated by combining RR and AR information with nativity-specific invasive breast cancer incidence and competing mortality rates from the California Cancer Registry and Surveillance, Epidemiology, and End Results program to develop the Hispanic risk model (HRM). In independent data, we assessed model calibration through observed/expected (O/E) ratios, and we estimated discriminatory accuracy with the area under the receiver operating characteristic curve (AUC) statistic.


The US-born HRM included age at first full-term pregnancy, biopsy for benign breast disease, and family history of breast cancer; the foreign-born HRM also included age at menarche. The HRM estimated lower risks than the National Cancer Institute's Breast Cancer Risk Assessment Tool (BCRAT) for US-born Hispanic women, but higher risks in foreign-born women. In independent data from the Women's Health Initiative, the HRM was well calibrated for US-born women (observed/expected [O/E] ratio = 1.07, 95% confidence interval [CI] = 0.81 to 1.40), but seemed to overestimate risk in foreign-born women (O/E ratio = 0.66, 95% CI = 0.41 to 1.07). The AUC was 0.564 (95% CI = 0.485 to 0.644) for US-born and 0.625 (95% CI = 0.487 to 0.764) for foreign-born women.


The HRM is the first absolute risk model that is based entirely on data specific to Hispanic women by nativity. Further studies in Hispanic women are warranted to evaluate its validity.

[Indexed for MEDLINE]
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