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Risk-Adjusted Cancer Screening and Prevention (RiskAP): Complementing Screening for Early Disease Detection by a Learning Screening Based on Risk Factors

Risk-Adjusted Cancer Screening and Prevention (RiskAP): Complementing Screening for Early Disease Detection by a Learning Screening Based on Risk Factors
Risk-Adjusted Cancer Screening and Prevention (RiskAP): Complementing Screening for Early Disease Detection by a Learning Screening Based on Risk Factors
Background: Risk-adjusted cancer screening and prevention is a promising and continuously emerging option for improving cancer prevention. It is driven by increasing knowledge of risk factors and the ability to determine them for individual risk prediction. However, there is a knowledge gap between evidence of increased risk and evidence of the effectiveness and efficiency of clinical preventive interventions based on increased risk. This gap is, in particular, aggravated by the extensive availability of genetic risk factor diagnostics, since the question of appropriate preventive measures immediately arises when an increased risk is identified. However, collecting proof of effective preventive measures, ideally by prospective randomized preventive studies, typically requires very long periods of time, while the knowledge about an increased risk immediately creates a high demand for action. Summary: Therefore, we propose a risk-adjusted prevention concept that is based on the best current evidence making needed and appropriate preventive measures available, and which is constantly evaluated through outcome evaluation, and continuously improved based on these results. We further discuss the structural and procedural requirements as well as legal and socioeconomical aspects relevant for the implementation of this concept.
Breast cancer, ELSI ethical, legal, social implications, Evidencegenerating care, Risk-adjusted prevention
1661-3791
208–223
Schmutzler, Rita K.
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Schmitz-Luhn, Bjorn
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Borisch, Bettina
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Devilee, Peter
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Eccles, Diana
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Hall, Per
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Balmaña, Judith
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Boccia, Stefania
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Dabrock, Peter
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Emons, Günter
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Gaissmaier, Wolfgang
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Gronwald, Jacek
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Houwaart, Stefanie
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Huster, Stefan
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Kast, Karin
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Katalinic, Alexander
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Linn, Sabine C.
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Matthijs, Gert
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Moorthie, Sowmiya
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Pharoah, Paul
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Rhiem, Kerstin
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Spranger, Tade
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Stoppa-Lyonnet, Dominique
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van Delden, Johannes Jozef Marten
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van den Bulcke, Marc
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Woopen, Christiane
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Schmutzler, Rita K.
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Schmitz-Luhn, Bjorn
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Borisch, Bettina
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Devilee, Peter
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Eccles, Diana
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Hall, Per
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Balmaña, Judith
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Boccia, Stefania
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Dabrock, Peter
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Emons, Günter
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Gaissmaier, Wolfgang
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Gronwald, Jacek
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Houwaart, Stefanie
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Huster, Stefan
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Kast, Karin
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Katalinic, Alexander
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Linn, Sabine C.
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Matthijs, Gert
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Moorthie, Sowmiya
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Pharoah, Paul
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Rhiem, Kerstin
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Spranger, Tade
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Stoppa-Lyonnet, Dominique
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van Delden, Johannes Jozef Marten
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van den Bulcke, Marc
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Woopen, Christiane
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Schmutzler, Rita K., Schmitz-Luhn, Bjorn, Borisch, Bettina, Devilee, Peter, Eccles, Diana, Hall, Per, Balmaña, Judith, Boccia, Stefania, Dabrock, Peter, Emons, Günter, Gaissmaier, Wolfgang, Gronwald, Jacek, Houwaart, Stefanie, Huster, Stefan, Kast, Karin, Katalinic, Alexander, Linn, Sabine C., Matthijs, Gert, Moorthie, Sowmiya, Pharoah, Paul, Rhiem, Kerstin, Spranger, Tade, Stoppa-Lyonnet, Dominique, van Delden, Johannes Jozef Marten, van den Bulcke, Marc and Woopen, Christiane (2022) Risk-Adjusted Cancer Screening and Prevention (RiskAP): Complementing Screening for Early Disease Detection by a Learning Screening Based on Risk Factors. Breast Care, 17 (2), 208–223. (doi:10.1159/000517182).

Record type: Review

Abstract

Background: Risk-adjusted cancer screening and prevention is a promising and continuously emerging option for improving cancer prevention. It is driven by increasing knowledge of risk factors and the ability to determine them for individual risk prediction. However, there is a knowledge gap between evidence of increased risk and evidence of the effectiveness and efficiency of clinical preventive interventions based on increased risk. This gap is, in particular, aggravated by the extensive availability of genetic risk factor diagnostics, since the question of appropriate preventive measures immediately arises when an increased risk is identified. However, collecting proof of effective preventive measures, ideally by prospective randomized preventive studies, typically requires very long periods of time, while the knowledge about an increased risk immediately creates a high demand for action. Summary: Therefore, we propose a risk-adjusted prevention concept that is based on the best current evidence making needed and appropriate preventive measures available, and which is constantly evaluated through outcome evaluation, and continuously improved based on these results. We further discuss the structural and procedural requirements as well as legal and socioeconomical aspects relevant for the implementation of this concept.

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RiskAP_final - Accepted Manuscript
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Accepted/In Press date: 23 March 2021
e-pub ahead of print date: 1 April 2022
Published date: 1 April 2022
Additional Information: Funding Information: The project was funded by the German Federal Ministry of Health (grant No. 2515FSB401 to Rita Schmutzler and Christiane Woopen) for supporting the international expert meetings, and a grant of the EU Horizon 2020 program, BRIDGES (grant No. 634935, PI Peter Devilee, WP5-PI Rita Schmutzler), for the compilation of the most recent findings of genetic risk prediction. Publisher Copyright: © 2022 S. Karger AG. All rights reserved.
Keywords: Breast cancer, ELSI ethical, legal, social implications, Evidencegenerating care, Risk-adjusted prevention

Identifiers

Local EPrints ID: 448208
URI: http://eprints.soton.ac.uk/id/eprint/448208
ISSN: 1661-3791
PURE UUID: 8d058ccc-52e8-4c23-b892-28d0d274fa5c
ORCID for Diana Eccles: ORCID iD orcid.org/0000-0002-9935-3169

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Date deposited: 15 Apr 2021 16:30
Last modified: 17 Mar 2024 06:29

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Contributors

Author: Rita K. Schmutzler
Author: Bjorn Schmitz-Luhn
Author: Bettina Borisch
Author: Peter Devilee
Author: Diana Eccles ORCID iD
Author: Per Hall
Author: Judith Balmaña
Author: Stefania Boccia
Author: Peter Dabrock
Author: Günter Emons
Author: Wolfgang Gaissmaier
Author: Jacek Gronwald
Author: Stefanie Houwaart
Author: Stefan Huster
Author: Karin Kast
Author: Alexander Katalinic
Author: Sabine C. Linn
Author: Gert Matthijs
Author: Sowmiya Moorthie
Author: Paul Pharoah
Author: Kerstin Rhiem
Author: Tade Spranger
Author: Dominique Stoppa-Lyonnet
Author: Johannes Jozef Marten van Delden
Author: Marc van den Bulcke
Author: Christiane Woopen

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