Understanding the contribution of lifestyle in breast cancer risk prediction: a systematic review of models applicable to Europe
Abstract Background Breast cancer (BC) is a significant health concern among European women, with the highest prevalence rates among all cancers. Existing BC prediction models account for major risks such as hereditary, hormonal and reproductive factors, but research suggests that adherence to a hea...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-023-11174-w |
| _version_ | 1827895115947966464 |
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| author | Elly Mertens Antonio Barrenechea-Pulache Diana Sagastume Maria Salve Vasquez Stefanie Vandevijvere José L. Peñalvo |
| author_facet | Elly Mertens Antonio Barrenechea-Pulache Diana Sagastume Maria Salve Vasquez Stefanie Vandevijvere José L. Peñalvo |
| author_sort | Elly Mertens |
| collection | DOAJ |
| description | Abstract Background Breast cancer (BC) is a significant health concern among European women, with the highest prevalence rates among all cancers. Existing BC prediction models account for major risks such as hereditary, hormonal and reproductive factors, but research suggests that adherence to a healthy lifestyle can reduce the risk of developing BC to some extent. Understanding the influence and predictive role of lifestyle variables in current risk prediction models could help identify actionable, modifiable, targets among high-risk population groups. Purpose To systematically review population-based BC risk prediction models applicable to European populations and identify lifestyle predictors and their corresponding parameter values for a better understanding of their relative contribution to the prediction of incident BC. Methods A systematic review was conducted in PubMed, Embase and Web of Science from January 2000 to August 2021. Risk prediction models were included if (i) developed and/or validated in adult cancer-free women in Europe, (ii) based on easily ascertained information, and (iii) reported models’ final predictors. To investigate further the comparability of lifestyle predictors across models, estimates were standardised into risk ratios and visualised using forest plots. Results From a total of 49 studies, 33 models were developed and 22 different existing models, mostly from Gail (22 studies) and Tyrer-Cuzick and co-workers (12 studies) were validated or modified for European populations. Family history of BC was the most frequently included predictor (31 models), while body mass index (BMI) and alcohol consumption (26 and 21 models, respectively) were the lifestyle predictors most often included, followed by smoking and physical activity (7 and 6 models respectively). Overall, for lifestyle predictors, their modest predictive contribution was greater for riskier lifestyle levels, though highly variable model estimates across different models. Conclusions Given the increasing BC incidence rates in Europe, risk models utilising readily available risk factors could greatly aid in widening the population coverage of screening efforts, while the addition of lifestyle factors could help improving model performance and serve as intervention targets of prevention programmes. |
| first_indexed | 2024-03-12T22:16:58Z |
| format | Article |
| id | doaj.art-83c133d4c51f474ea4b1c19bd9c251f0 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-03-12T22:16:58Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-83c133d4c51f474ea4b1c19bd9c251f02023-07-23T11:17:15ZengBMCBMC Cancer1471-24072023-07-0123111510.1186/s12885-023-11174-wUnderstanding the contribution of lifestyle in breast cancer risk prediction: a systematic review of models applicable to EuropeElly Mertens0Antonio Barrenechea-Pulache1Diana Sagastume2Maria Salve Vasquez3Stefanie Vandevijvere4José L. Peñalvo5Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical MedicineUnit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical MedicineUnit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical MedicineHealth Information, Scientific Institute of Public Health (Sciensano)Health Information, Scientific Institute of Public Health (Sciensano)Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical MedicineAbstract Background Breast cancer (BC) is a significant health concern among European women, with the highest prevalence rates among all cancers. Existing BC prediction models account for major risks such as hereditary, hormonal and reproductive factors, but research suggests that adherence to a healthy lifestyle can reduce the risk of developing BC to some extent. Understanding the influence and predictive role of lifestyle variables in current risk prediction models could help identify actionable, modifiable, targets among high-risk population groups. Purpose To systematically review population-based BC risk prediction models applicable to European populations and identify lifestyle predictors and their corresponding parameter values for a better understanding of their relative contribution to the prediction of incident BC. Methods A systematic review was conducted in PubMed, Embase and Web of Science from January 2000 to August 2021. Risk prediction models were included if (i) developed and/or validated in adult cancer-free women in Europe, (ii) based on easily ascertained information, and (iii) reported models’ final predictors. To investigate further the comparability of lifestyle predictors across models, estimates were standardised into risk ratios and visualised using forest plots. Results From a total of 49 studies, 33 models were developed and 22 different existing models, mostly from Gail (22 studies) and Tyrer-Cuzick and co-workers (12 studies) were validated or modified for European populations. Family history of BC was the most frequently included predictor (31 models), while body mass index (BMI) and alcohol consumption (26 and 21 models, respectively) were the lifestyle predictors most often included, followed by smoking and physical activity (7 and 6 models respectively). Overall, for lifestyle predictors, their modest predictive contribution was greater for riskier lifestyle levels, though highly variable model estimates across different models. Conclusions Given the increasing BC incidence rates in Europe, risk models utilising readily available risk factors could greatly aid in widening the population coverage of screening efforts, while the addition of lifestyle factors could help improving model performance and serve as intervention targets of prevention programmes.https://doi.org/10.1186/s12885-023-11174-wBreast cancerRisk predictionEuropeModel performanceLifestyleBMI |
| spellingShingle | Elly Mertens Antonio Barrenechea-Pulache Diana Sagastume Maria Salve Vasquez Stefanie Vandevijvere José L. Peñalvo Understanding the contribution of lifestyle in breast cancer risk prediction: a systematic review of models applicable to Europe BMC Cancer Breast cancer Risk prediction Europe Model performance Lifestyle BMI |
| title | Understanding the contribution of lifestyle in breast cancer risk prediction: a systematic review of models applicable to Europe |
| title_full | Understanding the contribution of lifestyle in breast cancer risk prediction: a systematic review of models applicable to Europe |
| title_fullStr | Understanding the contribution of lifestyle in breast cancer risk prediction: a systematic review of models applicable to Europe |
| title_full_unstemmed | Understanding the contribution of lifestyle in breast cancer risk prediction: a systematic review of models applicable to Europe |
| title_short | Understanding the contribution of lifestyle in breast cancer risk prediction: a systematic review of models applicable to Europe |
| title_sort | understanding the contribution of lifestyle in breast cancer risk prediction a systematic review of models applicable to europe |
| topic | Breast cancer Risk prediction Europe Model performance Lifestyle BMI |
| url | https://doi.org/10.1186/s12885-023-11174-w |
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