A study published in the British Journal of Cancer has compared the National Institute for Health and Care Excellence (NICE) criteria with the BOADICEA risk model for breast cancer risk assessment and referral among women under the age of 50.
Professor Paul Pharoah, Professor of Cancer Epidemiology at Cedars-Sinai Health Sciences University, noted the study's high quality. Researchers used a large group of women under 50, calculating their future cancer risk with the BOADICEA model and then following them for 10 years. The BOADICEA model performed well in assessing risk.
The study found that less than 5% of high-risk women and less than 5% of future breast cancer cases identified by BOADICEA were eligible for referral under NICE criteria. However, Professor Pharoah stated that the fundamental premise of these analyses was flawed, as NICE guidelines are intended to manage women concerned about their family history of breast cancer, not to identify all high-risk women.
Dr Adam Brentnall, Reader in Biostatistics at Queen Mary University of London (QMUL), described the research as good quality, using data from the Breast Cancer Now Generations Study. He highlighted that the study demonstrated the value of comprehensive breast cancer risk assessment over current criteria. However, he noted that the analysis was limited to white participants, indicating a need for more work across the UK's ethnic diversity.