Does the Breast Cancer Risk Assessment Tool (BCRAT) work for biracial women?

of Breast Cancer Risk Assessment Tool (BCRAT) An online calculator designed to predict a woman's risk of developing the disease. invasive breast cancer Both short-term (up to 5 years) and lifelong (up to age 90).

The tool is supposed to calculate your risk in about five minutes using factors from your medical history, such as age at menarche and number of first-degree relatives who have had breast cancer. It is available for free on the National Cancer Institute (NCI) website and is intended for health care professionals. Still, if you're as curious as I am, you can't resist filling out the quiz-like form yourself.

It was a fool's errand, after all. BCRAT was not designed for people like me. Or Man, for that matter.

In the demographics section, the assessment asks, “What is the patient's race/ethnicity?” The drop-down menu has six options: “Caucasian,” “African American,” “Hispana/Latino,” “Asian American,” “American Indian or Alaska Native,” and “Unknown.” had. None of these options are useful on their own, and I only had one choice.

Ask any biracial or multiracial person what it's like to fill out a form, and they'll likely tell you their story. As the daughter of a black father and a white mother, I have my own rights. For decades, my options have been “other,” “biracial,” “multiracial,” “mixed race,” “other race,” or exotics like “two or more races.” It has expanded to include other categories. Sometimes you have the luxury of choosing two.

Unfortunately, however, the lack of appropriate racial/ethnic categories in BCRAT can have serious consequences.

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No wonder there isn't a single biracial/multiracial option. I think my risk as a black/white person is different than that of a woman with an Asian/white background like Mann, for example. However, in the age of AI, it goes without saying that Rapidly increasing multi-ethnic population In the US, could an algorithm choose between the two and calculate the risk?

NCI acknowledges the limitations of BCRAT, namely the lack of diverse racial and ethnic data that can skew the results. This tool may underestimate risk for Black women and Hispanic women born outside the U.S. who have had a prior biopsy, and provides inaccurate risk estimates for American Indian and Alaska Native women. there's a possibility that.

“The more data we can feed algorithms, predictive tools, and AI, the better it can give us an answer, in this case a risk estimate.” Dr. Robin Hinescancer epidemiologist University of Central Florida School of Medicine,Tell you luck. “If you have 280,000 women, the margin of error in your estimates is much lower than if you have just over 3,000 women.”

Hines is referring to the 280,000 white women in the world. Breast cancer detection demonstration project. their data and NCI Surveillance, Epidemiology, and End Results (SEER) Program, was used to create BCRAT. Risk estimates for non-whites are based on her SEER and other study data on far fewer women from the following racial and ethnic groups:

• black: 3,244
• Hispanic: 2,497
• Asian and Pacific Islanders: 1,563

Dr. Mitchell Galecurrently a senior investigator. NCI Division of Cancer Epidemiology and Genetics Division of Biostatisticsdeveloped the calculator in 1989. National Institutes of Health Revitalization Act of 1993 It called for “increasing the number of women and individuals from disadvantaged backgrounds (including racial and ethnic minorities) in the fields of biomedical and behavioral research.”Also known as gale modelAccording to the NCI, the BCRAT algorithm was last revised in 2017 and may be updated periodically as new data becomes available.

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I took the BCRAT twice. If you typed in “African American,” the tool generated a lifetime risk of 9.8%, but the average risk for a 35-year-old black woman in the United States was her 10.1%. If you typed in “white,” the risk jumped to 12.4%. , compared to an average of 12.6%. I don't know the nuances of the algorithm, but my interracial risk is probably more complex than simply averaging the two scores.

So what happened to Mann's obstetrics and gynecology department? Dr. Tais Aliabadi, Calculating the Risks of a Biracial Actress?Mr. Aliabadi is making preparations. start the calculator On her new podcast website, she is a medical doctordid not specify which assessment tool it was, but BCRAT one of many–She used it for Mann. But Aliabadi says she wants all women to understand the risks of breast cancer. luck The problem is the lack of racially and ethnically diverse tools.

“We have great tools available to the public, but clearly we need to do more research and focus more on different ethnicities,” she says. “We hope that by collecting more data and artificial intelligence, we will be able to integrate all this data and come up with better tests.”

Progress is already being made.of Black Women's Health Study Breast Cancer Risk Calculator Released in 2021, Estimate short-term risk Targeted at women aged 30 to 70. The 10-year risk was 0.8%, compared with an average of 0.9%.

President Joe Biden signed it on Monday. Executive Order on Advancing Research and Innovation in Women's HealthIt acknowledges that “little is known about women's health across the lifespan, and the gap is even more pronounced for women of color, older women, and women with disabilities.” An investment of federal dollars is required to fill this gap.

For now, Aliabadi's biggest concern is that not enough women, regardless of race or ethnicity, myself included, are aware of their high-level risks. “The real problem,” she says, is that she is 35 years old and had never heard of her breast cancer risk assessment until Mann's announcement on her Instagram. While I am frustrated that most of the existing tools do not or cannot take biracial women into account, I feel like I at least now understand my risks. Although my estimates are relatively low, it raises questions I would like to ask my doctor.

“I want to change this and provide a standard of care for all women, not just high-risk women,” Aliabadi says. luck. “It'll take about two minutes. Look at how much time we spend doing other things in our lives. How many minutes does he need to calculate his lifetime risk of breast cancer?”

Learn more about breast cancer risk and prevention below.

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