Up to 95% of younger women at higher risk of developing breast cancer are being missed by current National Health Service (NHS) checks, according to a new study. Breast cancer is a leading cause of death for women under 50 in the UK, and while most cases occur in women over 40, a significant number still develop the disease at younger ages. Current NHS guidelines, recommended by the National Institute for Health and Care Excellence (NICE), primarily rely on family history to identify women at increased risk. However, researchers found that this approach overlooks a vast majority of younger women who later develop breast cancer.
The study, conducted by a team from Cambridge University and the Institute of Cancer Research, utilized a risk assessment calculator named Boadicea. This tool combines multiple factors, including family history, lifestyle habits, reproductive history, and genetic information, to generate a comprehensive risk score. The researchers estimate that if all women under 50 were assessed using Boadicea, approximately 26.5% would be flagged as having an above-average risk and would be referred for further evaluation. This would include a substantial portion, 34.8%, of women under 50 who are projected to develop breast cancer within the next 10 years.
In contrast, the current NICE criteria would lead to only 1.4% of women under 50 being referred for additional assessments. This discrepancy is largely due to the fact that a significant majority, 73%, of women under 50 who develop breast cancer within a decade have no prior family history of the disease, which is the key determinant in the existing NICE guidelines. The findings suggest that the current methods are failing to identify many younger individuals who are susceptible to breast cancer, highlighting a critical gap in preventative screening.
Breast cancer affects about one in seven women over their lifetime, with inherited genes accounting for only 5-10% of cases. The majority of diagnoses, 96%, are in women over 40, and 25% are in women over 75. While men can also develop breast cancer, with around 420 new cases annually in the UK, the study focuses on risk assessment in women. Factors such as alcohol intake and obesity are known to increase risk, alongside hormonal influences from oral contraceptives and hormone replacement therapy, which NICE considers for women over 35 or those using these treatments. The Boadicea tool aims to provide a more nuanced and accurate prediction of risk by incorporating a wider range of personal health data.