PMID- 31725845 OWN - NLM STAT- MEDLINE DCOM- 20220310 LR - 20220422 IS - 2374-2445 (Electronic) IS - 2374-2437 (Print) IS - 2374-2437 (Linking) VI - 6 IP - 1 DP - 2020 Jan 1 TI - Risk-Adapted Starting Age of Screening for Relatives of Patients With Breast Cancer. PG - 68-74 LID - 10.1001/jamaoncol.2019.3876 [doi] AB - IMPORTANCE: Breast cancer screening guidelines acknowledge the need for earlier screening for women at increased risk but provide limited guidance for women with a family history of breast cancer. A risk-adapted starting age of screening for relatives of patients with breast cancer may help supplement current screening guidelines. OBJECTIVE: To identify the risk-adapted starting age of breast cancer screening on the basis of a woman's detailed family history. DESIGN, SETTING, AND PARTICIPANTS: This nationwide cohort study analyzed data recorded in the Swedish family-cancer data sets. All women born from 1932 onward and with at least 1 known first-degree relative (FDR) were included (N = 5 099 172). Data from January 1, 1958, to December 31, 2015, were collected. Data were analyzed from October 1, 2017, to March 31, 2019. EXPOSURES: Family history of breast cancer in FDRs and second-degree relatives (SDRs). MAIN OUTCOMES AND MEASURES: Primary invasive breast cancer diagnosis and the age at which women with different constellations of family history attained the risk level at which breast screening is usually recommended. RESULTS: Of the 5 099 172 women included in the study, 118 953 (2.3%) received a diagnosis of primary invasive breast cancer. A total of 102 751 women (86.4%; mean [SD] age at diagnosis, 55.9 [11.1] years) did not have family history of breast cancer in FDRs and SDRs at the time of their diagnosis. Risk-adapted starting age of breast cancer screening varied by number of FDRs and SDRs with breast cancer diagnosis and the age at diagnosis of the FDRs. For example, for screening recommendation at age 50 years for the general population (2.2% 10-year cumulative risk), women with multiple affected FDRs, with the youngest affected relative receiving a diagnosis before age 50 years, reached the benchmark risk level at age 27 years. When the youngest relative received a diagnosis after age 50 years, however, this risk level was attained at age 36 years. CONCLUSIONS AND RELEVANCE: This study identifies possible risk-based starting ages for breast cancer screening based on population-based registers. These results may serve as high-quality evidence to supplement current screening guidelines for relatives of patients with breast cancer. FAU - Mukama, Trasias AU - Mukama T AD - Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases, Heidelberg, Germany. AD - Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany. AD - School of Public Health, College of Health Sciences, Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda. FAU - Kharazmi, Elham AU - Kharazmi E AD - Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases, Heidelberg, Germany. AD - Center for Primary Health Care Research, Lund University, Malmo, Sweden. FAU - Xu, Xing AU - Xu X AD - Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases, Heidelberg, Germany. AD - Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany. FAU - Sundquist, Kristina AU - Sundquist K AD - Center for Primary Health Care Research, Lund University, Malmo, Sweden. AD - Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York. AD - Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Sundquist, Jan AU - Sundquist J AD - Center for Primary Health Care Research, Lund University, Malmo, Sweden. AD - Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York. AD - Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Brenner, Hermann AU - Brenner H AD - Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases, Heidelberg, Germany. AD - Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany. AD - German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany. FAU - Fallah, Mahdi AU - Fallah M AD - Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases, Heidelberg, Germany. AD - Center for Primary Health Care Research, Lund University, Malmo, Sweden. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA Oncol JT - JAMA oncology JID - 101652861 SB - IM CIN - JAMA Oncol. 2020 Jan 1;6(1):31-33. PMID: 31725821 EIN - JAMA Oncol. 2019 Dec 12;:. PMID: 31830231 CIN - Quant Imaging Med Surg. 2020 Apr;10(4):886-890. PMID: 32355656 CIN - JAMA Oncol. 2020 Jun 1;6(6):933-934. PMID: 32379276 CIN - JAMA Oncol. 2020 Jun 1;6(6):934-935. PMID: 32379279 CIN - Quant Imaging Med Surg. 2020 Dec;10(12):2401-2407. PMID: 33269240 MH - Adult MH - *Breast Neoplasms/diagnosis/epidemiology/genetics MH - Cohort Studies MH - Early Detection of Cancer/methods MH - Female MH - Humans MH - Mass Screening MH - Medical History Taking MH - Middle Aged MH - Risk Factors PMC - PMC6865319 COIS- Conflict of Interest Disclosures: None reported. EDAT- 2019/11/15 06:00 MHDA- 2022/03/11 06:00 PMCR- 2020/11/14 CRDT- 2019/11/15 06:00 PHST- 2019/11/15 06:00 [pubmed] PHST- 2022/03/11 06:00 [medline] PHST- 2019/11/15 06:00 [entrez] PHST- 2020/11/14 00:00 [pmc-release] AID - 2755638 [pii] AID - coi190080 [pii] AID - 10.1001/jamaoncol.2019.3876 [doi] PST - ppublish SO - JAMA Oncol. 2020 Jan 1;6(1):68-74. doi: 10.1001/jamaoncol.2019.3876.