Evidence map›Paper›PMID 37306245›Full record

ArticleJournal of medical screening2023

Risk of cancer versus risk of cancer diagnosis? Accounting for diagnostic bias in predictions of breast cancer risk by race and ethnicity.

Charlotte C Gard, Jane Lange, Diana L Miglioretti, Ellen S O'Meara, Christoph I Lee, Ruth Etzioni

Open access · greenAbstract readComparative Study
In one paragraph

Article in Journal of medical screening, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Performance of Statistical and Machine Learning Risk Prediction Models for Advanced Breast Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Charlotte C GardDepartment of Economics, Applied Statistics, and International Business, New Mexico State University, Las Cruces, NM, USA.ORCID 0000-0001-7201-4450
Jane LangeKnight Cancer Institute, Oregon Health and Science University, Portland, OR, USA.ORCID 0000-0002-0014-9679
Diana L MigliorettiDepartment of Public Health Sciences, University of California Davis School of Medicine, Davis, CA, USA.ORCID 0000-0002-5547-1833
Ellen S O'MearaKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Christoph I LeeDepartment of Radiology, University of Washington School of Medicine, Seattle, WA, USA.ORCID 0000-0002-8185-7721
Ruth EtzioniPublic Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.ORCID 0000-0002-9164-6370
Kaiser Permanente Washington Health Research Institute · USUniversity of Washington · USNew Mexico State University · USOregon Health & Science University · US

Funding

Risk-based Imaging Strategies to Improve Breast Cancer Surveillance OutcomesP01CA154292 · NCI · UNIVERSITY OF CALIFORNIA AT DAVIS · PI KARLA M KERLIKOWSKE · 2011 to 2026
$52.9M
Research Education About Cancer and Health (REACH) CoreU54CA132381 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI Jean Alison McDougall · 2007 to 2026
$25.3M
Undergraduate Student Training in Cancer ResearchU54CA132383 · NCI · NEW MEXICO STATE UNIVERSITY LAS CRUCES · PI MICHELE Irene SHUSTER · 2007 to 2026
$21.4M
Vermont Screening Process Documentation UnitU54CA163303 · NCI · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI SPRAGUE, BRIAN L · 2011 to 2017
$6.4M
Racial and Socioeconomic Disparities in Breast Cancer Diagnostic Work Up and OutcomesR01CA266377 · NCI · UNIVERSITY OF WISCONSIN-MADISON · PI LEE, CHRISTOPH I · 2021 to 2025
$3.1M
Comparative effectiveness of breast imaging modalities: a natural experimentR01HS018366 · AHRQ · UNIVERSITY OF ILLINOIS AT CHICAGO · PI RAUSCHER, GARTH H · 2010 to 2014
$1.8M
AHRQ HHS R01 HS018366NCI NIH HHS P01 CA154292NCI NIH HHS R01 CA266377NCI NIH HHS U54 CA132381NCI NIH HHS U54 CA132383NCI NIH HHS U54 CA163303
6 · The paper itself

Abstract

objectivesCancer risk prediction may be subject to detection bias if utilization of screening is related to cancer risk factors. We examine detection bias when predicting breast cancer risk by race/ethnicity.

methodsWe used screening and diagnosis histories from the Breast Cancer Surveillance Consortium to estimate risk of breast cancer onset and calculated relative risk of onset and diagnosis for each racial/ethnic group compared with non-Hispanic White women.

resultsOf 104,073 women aged 40-54 receiving their first screening mammogram at a Breast Cancer Surveillance Consortium facility between 2000 and 2018, 10.2% (n = 10,634) identified as Asian, 10.9% (n = 11,292) as Hispanic, and 8.4% (n = 8719) as non-Hispanic Black. Hispanic and non-Hispanic Black women had slightly lower screening frequencies but biopsy rates following a positive mammogram were similar across groups. Risk of cancer diagnosis was similar for non-Hispanic Black and White women (relative risk vs non-Hispanic White = 0.90, 95% CI 0.65 to 1.14) but was lower for Asian (relative risk = 0.70, 95% CI 0.56 to 0.97) and Hispanic women (relative risk = 0.82, 95% CI 0.62 to 1.08). Relative risks of disease onset were 0.78 (95% CI 0.68 to 0.88), 0.70 (95% CI 0.59 to 0.83), and 0.95 (95% CI 0.84 to 1.09) for Asian, Hispanic, and non-Hispanic Black women, respectively.

conclusionsRacial/ethnic differences in mammography and biopsy utilization did not induce substantial detection bias; relative risks of disease onset were similar to or modestly different than relative risks of diagnosis. Asian and Hispanic women have lower risks of developing breast cancer than non-Hispanic Black and White women, who have similar risks.

Indexed as

Breast NeoplasmsEthnicityAdultAsianBlack or African AmericanEarly Detection of CancerFemaleHispanic or LatinoHumansMiddle AgedRisk FactorsWhite PeopleBreast Cancer Surveillance Consortiumcancer screeningDetection biasdisease surveillancelatent modelrisk prediction

Identifiers

PMID37306245
PMCPMC10713859
OpenAlexW4380291646

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.