Razvoj in implementacija orodja za določanje individualne ogroženosti z rakom dojk v slovenski populaciji
Danes poznamo različne matematične modele za izračunavanje individualne ogroženosti za raka dojk. Trenutno je kot najbolj dosleden model razpoznan Tyrer-Cuzickov algoritem vključen v program IBIS. V Sloveniji smo v okviru Ciljnega raziskovalnega projekta Razvoj in implementacija orodja za določanje individualne ogroženosti za rakom dojk v slovenski populaciji, ki ga izvajamo na Onkološkem inštitutu Ljubljana, razvili program S-IBIS, ki je namenjen izračunavanju individualne ogroženosti za raka dojk slovenskih žensk. Gre za prilagoditev programa IBIS, kjer je v izračunih uporabljena slovenska generacijsko specifična populacijska ogroženost za raka dojk. Slovenski IBIS (S-IBIS) je pripravljen za uporabo v slovenskem zdravstvenem sistemu in omogoča z dokazi podprto razvrščanje asimptomatske posameznice v skupino splošno, zmerno in visoko ogroženih za raka dojk. Kot mejo za uvrstitev Slovenke stare 25 let med zmerno ogrožene za rakom dojk predlagamo vrednost doživljenjskega tveganja izračunanega s programom S-IBIS 16 ali več odstotkov, podane pa so tudi mejne vrednosti na podlagi deset-letne ogroženosti. V primerjavi z današnjim sistemom, ko Pravilnik za izvajanje preventivnega zdravstvenega varstva na primarni ravni opredeljuje bolj ogrožene ženske samo na podlagi nekaj zelo ohlapnih kvalitativnih kriterijev, je možno s programom S-IBIS asimptomaske ženske v skupine ogroženosti razvrstiti na podlagi individualnih numeričnih kriterijev. Pilotno preizkušanje programa v Centrih za bolezni dojk kaže spodbudne rezultate % verjamemo, da bi implementacija S-IBIS v slovenski zdravstveni sistem lahko zmanjšala število nepotrebnih preventivnih intervencij, hkrati pa bi se zmanjšale tudi čakalne dobe za upravičene preventivne preglede zmerno in visoko ogroženih žensk.
Various mathematical models for calculating individual breast cancer risk are known nowadays. Currently, the Tyrer-Cuzick algorithm included in the IBIS program is recognized as the most consistent one. In Slovenia, the S-IBIS software was developed within the framework of the Targeted Research Project Development and Implementation of Personalised Breast Cancer Risk Evaluation Tool for Slovenian Population, which is being carried out at the Institute of Oncology Ljubljana. Slovenian IBIS (S-IBIS) is specifically designed to calculate the individual risk of breast cancer in Slovenian women. It is an adjustment of the IBIS software, where Slovenian generation specific population breast cancer risks are applied. S-IBIS is ready for use in the Slovene health system and allows an evidence-based assignment of an asymptomatic individual to a group of general, moderate and high breast cancer risk. As a cut-off for the moderate risk group the S-IBIS life-time risk of 16 percent or more is suggested for a Slovene women at age 25. The cut-offs for ten-years risk are offered as well. Compared with today's system, where the Terms of the health prevention at the primary health care level classifies breast cancer high risk women applying very subjective qualitative criteria, it is today already possible to classify asymptomatic Slovenian women to a group of general, moderate and high breast cancer risk on the basis of individual numerical criteria using S-IBIS software. Pilot testing of the S-IBIS in the national Breast Disease Centers shows encouraging results - we believe that the implementation of S-IBIS in the Slovenian healthcare system could reduce the number of unnecessary preventive interventions, while also reducing the waiting time for justified preventive examinations of moderate and high risk women.
by Authors
2018
2019-02-06 11:20:58
1060
rak dojke, preventivna mamografija, individualna ogroženost, računalniški programi
breast cancer, individual risk calculation, S-IBIS software, preventive mamography
Vesna
Zadnik
70
Mateja
Krajc
70
UDK
4
614.2
ISSN pri članku
9
1408-1741
DOI
15
10.25670/oi2018-016on
COBISS_ID
3
3137147
OceCobissID
13
65324032
RAZ_Zadnik_Vesna_i2018.pdf
142604
Predstavitvena datoteka
2019-02-06 11:21:04