Elevated risk thresholds predict endocrine risk-reducing medication use in the Athena screening registry

Abstract Risk-reducing endocrine therapy use, though the benefit is validated, is extremely low. The FDA has approved tamoxifen and raloxifene for a 5-year Breast Cancer Risk Assessment Tool (BCRAT) risk ≥ 1.67%. We examined the threshold at which high-risk women are likely to be using endocrine ris...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Yash S. Huilgol, Holly Keane, Yiwey Shieh, Robert A. Hiatt, Jeffrey A. Tice, Lisa Madlensky, Leah Sabacan, Allison Stover Fiscalini, Elad Ziv, Irene Acerbi, Mandy Che, Hoda Anton-Culver, Alexander D. Borowsky, Sharon Hunt, Arash Naeim, Barbara A. Parker, Laura J. van ‘T Veer, Athena Breast Health Network Investigators and Advocate Partners, Laura J. Esserman
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/91eaf37ec54149658dd7d48f84d13d80
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:91eaf37ec54149658dd7d48f84d13d80
record_format	dspace
spelling	oai:doaj.org-article:91eaf37ec54149658dd7d48f84d13d802021-12-02T16:35:32ZElevated risk thresholds predict endocrine risk-reducing medication use in the Athena screening registry10.1038/s41523-021-00306-92374-4677https://doaj.org/article/91eaf37ec54149658dd7d48f84d13d802021-08-01T00:00:00Zhttps://doi.org/10.1038/s41523-021-00306-9https://doaj.org/toc/2374-4677Abstract Risk-reducing endocrine therapy use, though the benefit is validated, is extremely low. The FDA has approved tamoxifen and raloxifene for a 5-year Breast Cancer Risk Assessment Tool (BCRAT) risk ≥ 1.67%. We examined the threshold at which high-risk women are likely to be using endocrine risk-reducing therapies among Athena Breast Health Network participants from 2011–2018. We identified high-risk women by a 5-year BCRAT risk ≥ 1.67% and those in the top 10% and 2.5% risk thresholds by age. We estimated the odds ratio (OR) of current medication use based on these thresholds using logistic regression. One thousand two hundred and one (1.2%) of 104,223 total participants used medication. Of the 33,082 participants with 5-year BCRAT risk ≥ 1.67%, 772 (2.3%) used medication. Of 2445 in the top 2.5% threshold, 209 (8.6%) used medication. Participants whose 5-year risk exceeded 1.67% were more likely to use medication than those whose risk was below this threshold, OR 3.94 (95% CI = 3.50–4.43). The top 2.5% was most strongly associated with medication usage, OR 9.50 (8.13–11.09) compared to the bottom 97.5%. Women exceeding a 5-year BCRAT ≥ 1.67% had modest medication use. We demonstrate that women in the top 2.5% have higher odds of medication use than those in the bottom 97.5% and compared to a risk of 1.67%. The top 2.5% threshold would more effectively target medication use and is being tested prospectively in a randomized control clinical trial.Yash S. HuilgolHolly KeaneYiwey ShiehRobert A. HiattJeffrey A. TiceLisa MadlenskyLeah SabacanAllison Stover FiscaliniElad ZivIrene AcerbiMandy CheHoda Anton-CulverAlexander D. BorowskySharon HuntArash NaeimBarbara A. ParkerLaura J. van ‘T VeerAthena Breast Health Network Investigators and Advocate PartnersLaura J. EssermanNature PortfolioarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENnpj Breast Cancer, Vol 7, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Yash S. Huilgol Holly Keane Yiwey Shieh Robert A. Hiatt Jeffrey A. Tice Lisa Madlensky Leah Sabacan Allison Stover Fiscalini Elad Ziv Irene Acerbi Mandy Che Hoda Anton-Culver Alexander D. Borowsky Sharon Hunt Arash Naeim Barbara A. Parker Laura J. van ‘T Veer Athena Breast Health Network Investigators and Advocate Partners Laura J. Esserman Elevated risk thresholds predict endocrine risk-reducing medication use in the Athena screening registry
description	Abstract Risk-reducing endocrine therapy use, though the benefit is validated, is extremely low. The FDA has approved tamoxifen and raloxifene for a 5-year Breast Cancer Risk Assessment Tool (BCRAT) risk ≥ 1.67%. We examined the threshold at which high-risk women are likely to be using endocrine risk-reducing therapies among Athena Breast Health Network participants from 2011–2018. We identified high-risk women by a 5-year BCRAT risk ≥ 1.67% and those in the top 10% and 2.5% risk thresholds by age. We estimated the odds ratio (OR) of current medication use based on these thresholds using logistic regression. One thousand two hundred and one (1.2%) of 104,223 total participants used medication. Of the 33,082 participants with 5-year BCRAT risk ≥ 1.67%, 772 (2.3%) used medication. Of 2445 in the top 2.5% threshold, 209 (8.6%) used medication. Participants whose 5-year risk exceeded 1.67% were more likely to use medication than those whose risk was below this threshold, OR 3.94 (95% CI = 3.50–4.43). The top 2.5% was most strongly associated with medication usage, OR 9.50 (8.13–11.09) compared to the bottom 97.5%. Women exceeding a 5-year BCRAT ≥ 1.67% had modest medication use. We demonstrate that women in the top 2.5% have higher odds of medication use than those in the bottom 97.5% and compared to a risk of 1.67%. The top 2.5% threshold would more effectively target medication use and is being tested prospectively in a randomized control clinical trial.
format	article
author	Yash S. Huilgol Holly Keane Yiwey Shieh Robert A. Hiatt Jeffrey A. Tice Lisa Madlensky Leah Sabacan Allison Stover Fiscalini Elad Ziv Irene Acerbi Mandy Che Hoda Anton-Culver Alexander D. Borowsky Sharon Hunt Arash Naeim Barbara A. Parker Laura J. van ‘T Veer Athena Breast Health Network Investigators and Advocate Partners Laura J. Esserman
author_facet	Yash S. Huilgol Holly Keane Yiwey Shieh Robert A. Hiatt Jeffrey A. Tice Lisa Madlensky Leah Sabacan Allison Stover Fiscalini Elad Ziv Irene Acerbi Mandy Che Hoda Anton-Culver Alexander D. Borowsky Sharon Hunt Arash Naeim Barbara A. Parker Laura J. van ‘T Veer Athena Breast Health Network Investigators and Advocate Partners Laura J. Esserman
author_sort	Yash S. Huilgol
title	Elevated risk thresholds predict endocrine risk-reducing medication use in the Athena screening registry
title_short	Elevated risk thresholds predict endocrine risk-reducing medication use in the Athena screening registry
title_full	Elevated risk thresholds predict endocrine risk-reducing medication use in the Athena screening registry
title_fullStr	Elevated risk thresholds predict endocrine risk-reducing medication use in the Athena screening registry
title_full_unstemmed	Elevated risk thresholds predict endocrine risk-reducing medication use in the Athena screening registry
title_sort	elevated risk thresholds predict endocrine risk-reducing medication use in the athena screening registry
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/91eaf37ec54149658dd7d48f84d13d80
work_keys_str_mv	AT yashshuilgol elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT hollykeane elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT yiweyshieh elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT robertahiatt elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT jeffreyatice elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT lisamadlensky elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT leahsabacan elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT allisonstoverfiscalini elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT eladziv elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT ireneacerbi elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT mandyche elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT hodaantonculver elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT alexanderdborowsky elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT sharonhunt elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT arashnaeim elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT barbaraaparker elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT laurajvantveer elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT athenabreasthealthnetworkinvestigatorsandadvocatepartners elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry AT laurajesserman elevatedriskthresholdspredictendocrineriskreducingmedicationuseintheathenascreeningregistry
_version_	1718383706050134016

Elevated risk thresholds predict endocrine risk-reducing medication use in the Athena screening registry

Ejemplares similares