Low Risk Prediction Models for Black Women Causes Health Disparities

According to a Boston University School of Medicine study, the lack of breast cancer risk prediction models specifically tailored to Black women has created health disparities.

On average, Black women in the United States are more likely to develop breast cancer at earlier ages and with a worse prognosis than White women.

Due to the relatively small number of Black women enrolled in epidemiologic studies of breast cancer, efforts to derive and test models for use in Black women have been impacted. However, researchers from Boston University’s Sloane Epidemiology Center have developed and evaluated a risk prediction model for breast cancer in Black women, suitable for use in primary care settings.

“Because US Black women have a disproportionately high rate of breast cancer deaths, improvement in early detection of breast cancer in this population is critical, especially in young Black women who have not yet reached the ages at which mammographic screening is typically begun,” corresponding author Julie Palmer, ScD, said in a press release.

Breast cancer risk prediction tools are used by clinicians to identify women at an above-average risk of breast cancer. Medical professionals can then advise those women to receive early or more frequent screening by mammography and other modalities.

Palmer and colleagues used epidemiologic data from three case-control studies of Black women from various regions in the US to create a new risk prediction model. The research team tested the model using 15 years of follow-up data from 51,798 participants in the Boston University Black Women’s Health Study.

According to the press release, “The model was found to be well-calibrated. Discriminatory accuracy, which reflects how well a model predicts risk for an individual woman, was similar to that of the most frequently used questionnaire-based breast cancer risk prediction models in White women, and was best for women under age 40.”

The model is easy to use, and all the information required can be obtained from the women themselves with a few simple questions, according to the research team.

“This new tool for personalized prediction of breast cancer risk in Black women can be easily used by primary care providers to guide screening recommendations and/or referral for genetic testing, particularly for young Black women, thus leading to earlier diagnosis and reduced mortality,” said Palmer, who is also the director of BU’s Slone Epidemiology Center and is the Karin Grunebaum Professor in Cancer Research at Boston University School of Medicine.