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Background <p>BOADICEA is a widely used algorithm for predicting breast and ovarian cancer risks, using a combination of genetic and lifestyle, hormonal and reproductive risk factors. However, it has largely been developed using data from White/European individuals, limiting its applicability to other ethnicities. Here, we updated BOADICEA to provide ethnicity-specific risk estimates.</p> Methods <p>We utilised data from multiple sources to derive estimates for the distributions and effect sizes of risk factors in major UK ethnic groups (White, Black, South Asian, East Asian, and Mixed), along with ethnicity-specific population cancer incidences. We also developed a method for deriving adjusted polygenic scores for individuals of mixed genetic ancestry.</p> Results <p>The predicted average absolute risks were smaller in all non-White ethnic groups than in Whites, and the risk distributions were narrower. The proportion of women classified as at moderate or high risk of breast or ovarian cancer, according to national guidelines, was considerably smaller in non-Whites.</p> Discussion <p>The updated BOADICEA, available in the CanRisk tool (<a href="http://www.canrisk.org">www.canrisk.org</a>), is based on more appropriate estimates for non-White women in the UK. Further validation of the model in prospective studies is required. Considering these findings, risk classification guidelines for non-White women may need to be revised.</p>

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Adapting the BOADICEA breast and ovarian cancer risk models for the ethnically diverse UK population

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月17日

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  • Lorenzo Ficorella,
  • Xin Yang,
  • Nasim Mavaddat,
  • Tim Carver,
  • Hend Hassan,
  • Joe Dennis,
  • Jonathan Tyrer,
  • Weang-Kee Ho,
  • Soo-Hwang Teo,
  • Mikael Hartman,
  • Jingmei Li,
  • Mikael Eriksson,
  • Kamila Czene,
  • Per Hall,
  • Tameera Rahman,
  • Andrew Bacon,
  • Steven Hardy,
  • Adam E. Stokes,
  • Francisca Stutzin Donoso,
  • Stephanie Archer,
  • Jacques Simard,
  • Paul D. P. Pharoah,
  • Juliet A. Usher-Smith,
  • Marc Tischkowitz,
  • Douglas F. Easton,
  • Antonis C. Antoniou

摘要

Background

BOADICEA is a widely used algorithm for predicting breast and ovarian cancer risks, using a combination of genetic and lifestyle, hormonal and reproductive risk factors. However, it has largely been developed using data from White/European individuals, limiting its applicability to other ethnicities. Here, we updated BOADICEA to provide ethnicity-specific risk estimates.

Methods

We utilised data from multiple sources to derive estimates for the distributions and effect sizes of risk factors in major UK ethnic groups (White, Black, South Asian, East Asian, and Mixed), along with ethnicity-specific population cancer incidences. We also developed a method for deriving adjusted polygenic scores for individuals of mixed genetic ancestry.

Results

The predicted average absolute risks were smaller in all non-White ethnic groups than in Whites, and the risk distributions were narrower. The proportion of women classified as at moderate or high risk of breast or ovarian cancer, according to national guidelines, was considerably smaller in non-Whites.

Discussion

The updated BOADICEA, available in the CanRisk tool (www.canrisk.org), is based on more appropriate estimates for non-White women in the UK. Further validation of the model in prospective studies is required. Considering these findings, risk classification guidelines for non-White women may need to be revised.