Carmen Vidal

Institut d'Investigació Biomédica de Bellvitge

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Montse García

Institut Català d'Oncologia

Marina Pollán

GEICAM – Spanish Breast Cancer Group

Beatriz Pérez‐Gómez

Instituto de Salud Carlos III

Carmen Sánchez‐Contador

Health Research Institute of the Balearic Islands

Gemma Binefa

Bellvitge University Hospital

Pilar Moreo

Servicio Aragonés de Salud

Carmen Santamariña

Government of Spain

María Sala

Hospital Del Mar

María Ederra

Instituto de Salud Pública de Navarra

Virginia Lope

Instituto de Salud Carlos III

Cooperative Institutions

Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública

Instituto de Salud Carlos III

Institut Català d'Oncologia

Institut d'Investigació Biomédica de Bellvitge

Centro de Investigación Biomédica en Red

Universitat de Barcelona

Bellvitge University Hospital

Universitat Autònoma de Barcelona

Hospital del Mar Research Institute

Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana

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COVID-19 Incidence and Mortality in Patients Operated on for Breast Cancer. Comparison with the General Population

Clinical Breast Cancer (2022)

Israel Barco Carolina Chabrera Antonio García‐Fernández Manel Fraile Carmen Vidal

10.1016/j.clbc.2022.11.002

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Women’s preference to apply shared decision-making in breast cancer screening: a discrete choice experiment

BMJ Open (2022)

María José Hernández María José Pérez-Lacasta Àngels Cardona-Cardona Núria Codern‐Bové Carmen Vidal

Objective To analyse women’s stated preferences for establishing the relative importance of each attribute of shared decision-making (SDM) and their willingness to pay (WTP) for more participatory care in breast cancer screening programmes (BCSP). Design A discrete choice experiment was designed with 12 questions (choice tasks). It included three attributes: ‘How the information is obtained’, regarding benefits and harms; whether there is a ‘Dialogue for scheduled mammography’ between the healthcare professional and the woman; and, ‘Who makes the decision’, regarding participation in BCSP. Data were obtained using a survey that included 12 choice tasks, 1 question on WTP and 7 socioeconomic-related questions. The analysis was performed using conditional mixed-effect logit regression and stratification according to WTP. Setting Data collection related to BCSP was conducted between June and November 2021 in Catalonia, Spain. Participants Sixty-five women aged between 50 and 60. Main outcome measures Women’s perceived utility of each attribute, trade-off on these attributes and WTP for SDM in BCSP. Result The only significant attribute was ‘Who makes the decision’. The decision made alone (coefficient=2.879; 95% CI=2.297 to 3.461) and the decision made together with a healthcare professional (2.375; 95% CI=1.573 to 3.177) were the options preferred by women. The former contributes 21% more utility than the latter. Moreover, 52.3% of the women stated a WTP of €10 or more for SDM. Women’s preferences regarding attributes did not influence their WTP. Conclusions The participant women refused a current paternalistic model and preferred either SDM or informed decision-making in BCSP.

10.1136/bmjopen-2022-064488

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Changes in mammographic density over time and the risk of breast cancer: An observational cohort study

The Breast (2019)

Marta Román María Sala Marisa Baré Margarita Posso Carmen Vidal

Mammographic Density

Breast density

BI-RADS

Breast Cancer Screening

10.1016/j.breast.2019.04.007

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Citations (19)

Text message reminders cannot replace but can improve the effect of postal reminders to increase participation in colorectal cancer screening: a randomized controlled trial (Preprint)

Núria Vives Gemma Binefa Noémie Travier Albert Farré Jon Aritz Panera

BACKGROUND Mobile phone text message reminders to increase colorectal cancer (CRC) screening participation have shown moderate effects. OBJECTIVE We assessed the effectiveness of text messages as a replacement for routine postal reminders in a fecal immunochemical test (FIT) based colorectal cancer screening program in Catalonia. METHODS We conducted a randomized controlled trial among individuals aged 50 to 69 invited to screening who had not completed FIT within six weeks. The intervention group (n=12,167) received a text message reminder, and the control group (n=12,221) used the standard procedure (reminder letter). The primary outcome was a participation rate within 18 weeks of the invitation. The trial was discontinued, and a recovery strategy was implemented by sending a reminder letter to non-participant individuals from the intervention group. We performed a final analysis to determine the impact of the recovery strategy. RESULTS Interim analysis (n=7095) showed a lower participation rate among non-participants within six weeks in the text message group compared to the control group (16.4% vs. 20.9%, OR 0.71, 95% CI 0.63–0.81). A total of 7591 non-participants in the text message group received a second reminder by letter, reaching a participation rate of 23%. Final analysis (n=24,388) showed that the intervention group, which received two reminders, had higher participation than the control group (29.3% vs. 26.5%, OR 1.16, 95% CI 1.09–1.23). CONCLUSIONS Our attempt to replace reminder letters with text messages was unsuccessful, but receiving two reminders significantly increased participation rates among non-participants within six weeks compared to one postal reminder. Additional research is essential to determine the best timing and frequency of reminders to boost participation without being intrusive in their choice of participation. CLINICALTRIAL Clinicaltrials.gov NCT04343950, https://www.clinicaltrials.gov/study/NCT04343950 (04/09/2020).

Preprint

10.2196/preprints.64243

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Genome wide association study identifies a novel putative mammographic density locus at 1q12‐q21

International Journal of Cancer (2014)

Pablo Fernández‐Navarro Anna González‐Neira Guillermo Pita Ramón Dı́az-Uriarte Leticia T. Moreno

Mammographic density (MD) is an intermediate phenotype for breast cancer. Previous studies have identified genetic variants associated with MD; however, much of the genetic contribution to MD is unexplained. We conducted a two-stage genome-wide association analysis among the participants in the "Determinants of Density in Mammographies in Spain" study, together with a replication analysis in women from the Australian MD Twins and Sisters Study. Our discovery set covered a total of 3,351 Caucasian women aged 45 to 68 years, recruited from Spanish breast cancer screening centres. MD was blindly assessed by a single reader using Boyd's scale. A two-stage approach was employed, including a feature selection phase exploring 575,374 SNPs in 239 pairs of women with extreme phenotypes and a verification stage for the 183 selected SNPs in the remaining sample (2,873 women). Replication was conducted in 1,786 women aged 40 to 70 years old recruited via the Australian Twin Registry, where MD were measured using Cumulus-3.0, assessing 14 SNPs with a p value <0.10 in stage 2. Finally, two genetic variants in high linkage disequilibrium with our best hit were studied using the whole Spanish sample. Evidence of association with MD was found for variant rs11205277 (OR = 0.74; 95% CI = 0.67-0.81; p = 1.33 × 10(-10) ). In replication analysis, only a marginal association between this SNP and absolute dense area was found. There were also evidence of association between MD and SNPs in high linkage disequilibrium with rs11205277, rs11205303 in gene MTMR11 (OR = 0.73; 95% CI = 0.66-0.80; p = 2.64 × 10(-11) ) and rs67807996 in gene OTUD7B (OR = 0.72; 95% CI = 0.66-0.80; p = 2.03 × 10(-11)). Our findings provide additional evidence on common genetic variations that may contribute to MD.

Linkage Disequilibrium

Genome-wide Association Study

Genetic Association

Tag SNP

SNP

10.1002/ijc.29299

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Citations (19)

Réaction cutanée sévère associées aux antigènes leucocytes humains chez les Vietnamiens

Revue française d'allergologie (2019)

C. Chi Hieu N. Van Dinh Carmen Vidal Richard Fulton N. Nhu Nguyet

Allopurinol

10.1016/j.reval.2019.02.110

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PGT-A (preimplantational genetic screening) in patients with partial X monosomy using own oocytes: is a suitable indication?

Fertility and Sterility (2019)

Juan Gilés Amparo Mercader Carmen Rubio Carmen Vidal Lucía Alegre

Controlled ovarian hyperstimulation

Monosomy

Egg donation

10.1016/j.fertnstert.2019.07.1369

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Citations (1)

Longitudinal Adherence to Immunochemical Fecal Occult Blood Testing vs Guaiac-based FOBT in an Organized Colorectal Cancer Screening Program

Cancer Prevention Research (2019)

Llúcia Benito Noémie Travier Gemma Binefa Carmen Vidal José Espinosa

Longitudinal adherence is a critical component of the efficacy of stool-based screening programs because they should be repeated every 1-2 years. Few data have been published on the uptake in multiple rounds of fecal occult blood test-based (FOBT) colorectal cancer (CRC) screening. We calculated two measures of longitudinal adherence to biennial FOBT (guaiac fecal occult blood test:gFOBT or fecal immunochemical test:FIT) to better understand its impact on the programmatic effectiveness of a population-based CRC screening program (2000-2017). Ongoing population-based CRC program of men and women aged 50-69 years. Variables: Age at first CRC screening invitation, sex, number of screening invitations, number of screens, deprivation score, and uptake rate. Logistic regression models were used to assess the independent effect of sex, age at first invitation, deprivation, and the type of screening test offered on adherence. The uptake rate for guaiac fecal occult blood test (gFOBT) was 23.9%, and for the fecal immunochemical test (FIT), it was 37.4%. The overall rate of consistently screened invitees after seven rounds of screening was 14.2%, being 20.6% for those individuals who used FIT and 14.3% for those who used gFOBT. Factors associated with continued participation (consistent vs. inconsistent screenees) showed that the longitudinal adherence was associated with age, screening test used, and number of invitations. Continued participation was lower in individuals who were screened using FIT than among those screened using gFOBT [OR, 0.68; 95% confidence interval (CI), 0.57-0.81]. The overall rate of consistently screened invitees for colorectal cancer screening was higher with FIT than gFOBT. Studying the rate of individuals being current for screening may help to anticipate potential benefits before the long-term outcome data are available.

Fecal occult blood

Longitudinal Study

Colorectal cancer screening

10.1158/1940-6207.capr-18-0091

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Citations (13)

Evaluation of mammographic density patterns: reproducibility and concordance among scales

BMC Cancer (2010)

Macarena Garrido‐Estepa Francisco Ruiz-Perales Josefa Miranda Nieves Ascunce I. González-Román

Abstract Background Increased mammographic breast density is a moderate risk factor for breast cancer. Different scales have been proposed for classifying mammographic density. This study sought to assess intra-rater agreement for the most widely used scales (Wolfe, Tabár, BI-RADS and Boyd) and compare them in terms of classifying mammograms as high- or low-density. Methods The study covered 3572 mammograms drawn from women included in the DDM-Spain study, carried-out in seven Spanish Autonomous Regions. Each mammogram was read by an expert radiologist and classified using the Wolfe, Tabár, BI-RADS and Boyd scales. In addition, 375 mammograms randomly selected were read a second time to estimate intra-rater agreement for each scale using the kappa statistic. Owing to the ordinal nature of the scales, weighted kappa was computed. The entire set of mammograms (3572) was used to calculate agreement among the different scales in classifying high/low-density patterns, with the kappa statistic being computed on a pair-wise basis. High density was defined as follows: percentage of dense tissue greater than 50% for the Boyd, "heterogeneously dense and extremely dense" categories for the BI-RADS, categories P2 and DY for the Wolfe, and categories IV and V for the Tabár scales. Results There was good agreement between the first and second reading, with weighted kappa values of 0.84 for Wolfe, 0.71 for Tabár, 0.90 for BI-RADS, and 0.92 for Boyd scale. Furthermore, there was substantial agreement among the different scales in classifying high- versus low-density patterns. Agreement was almost perfect between the quantitative scales, Boyd and BI-RADS, and good for those based on the observed pattern, i.e., Tabár and Wolfe (kappa 0.81). Agreement was lower when comparing a pattern-based (Wolfe or Tabár) versus a quantitative-based (BI-RADS or Boyd) scale. Moreover, the Wolfe and Tabár scales classified more mammograms in the high-risk group, 46.61 and 37.32% respectively, while this percentage was lower for the quantitative scales (21.89% for BI-RADS and 21.86% for Boyd). Conclusions Visual scales of mammographic density show a high reproducibility when appropriate training is provided. Their ability to distinguish between high and low risk render them useful for routine use by breast cancer screening programs. Quantitative-based scales are more specific than pattern-based scales in classifying populations in the high-risk group.

Kappa

Concordance

Mammographic Density

Cohen's kappa

Breast density

BI-RADS

Ordinal Scale

10.1186/1471-2407-10-485

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Citations (50)

Adult weight gain, fat distribution and mammographic density in Spanish pre- and post-menopausal women (DDM-Spain)

Breast Cancer Research and Treatment (2012)

Marina Pollán Virginia Lope Josefa Miranda-García Milagros García Francisco Javier Bernal Casanova

High mammographic density (MD) is a phenotype risk marker for breast cancer. Body mass index (BMI) is inversely associated with MD, with the breast being a fat storage site. We investigated the influence of abdominal fat distribution and adult weight gain on MD, taking age, BMI and other confounders into account. Because visceral adiposity and BMI are associated with breast cancer only after menopause, differences in pre- and post-menopausal women were also explored. We recruited 3,584 women aged 45-68 years within the Spanish breast cancer screening network. Demographic, reproductive, family and personal history data were collected by purpose-trained staff, who measured current weight, height, waist and hip circumferences under the same protocol and with the same tools. MD was assessed in the left craniocaudal view using Boyd's Semiquantitative Scale. Association between waist-to-hip ratio, adult weight gain (difference between current weight and self-reported weight at 18 years) and MD was quantified by ordinal logistic regression, with random center-specific intercepts. Models were adjusted for age, BMI, breast size, time since menopause, parity, family history of breast cancer and hormonal replacement therapy use. Natural splines were used to describe the shape of the relationship between these two variables and MD. Waist-to-hip ratio was inversely associated with MD, and the effect was more pronounced in pre-menopausal (OR = 0.53 per 0.1 units; 95 % CI = 0.42-0.66) than in post-menopausal women (OR = 0.73; 95 % CI = 0.65-0.82) (P of heterogeneity = 0.010). In contrast, adult weight gain displayed a positive association with MD, which was similar in both groups (OR = 1.17 per 6 kg; 95 % CI = 1.11-1.23). Women who had gained more than 24 kg displayed higher MD (OR = 2.05; 95 % CI = 1.53-2.73). MD was also evaluated using Wolfe's and Tabár's classifications, with similar results being obtained. Once BMI, fat distribution and other confounders were considered, our results showed a clear dose-response gradient between the number of kg gained during adulthood and the proportion of dense tissue in the breast.

Waist–hip ratio

10.1007/s10549-012-2108-3

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Citations (35)