Razvoj modela za predviđanje intervalnoga raka dojke na temelju pokazatelja Nacionalnoga programa ranog otkrivanja raka dojke u Republici Hrvatskoj

doctoral thesis

• Title (english): Development of a model for predicting interval breast cancer based on the indicators of the National Program for Early Detection of Breast Cancer in the Republic of Croatia
• Author: Romana Tandara Haček
• Mentor: Nataša Antoljak (mentor)
• Committee member: Mirjana Kujundžić Tiljak (predsjednik povjerenstva)
• Committee member: Sanja Musić Milanović (član povjerenstva)
• Committee member: Vanja Tešić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-05-24, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Epidemiology
• Universal decimal classification (UDC): 614 - Public health and hygiene. Accident prevention

Abstract

Cilj rada bio je razvoj modela za predviđanje intervalnoga raka dojke na temelju pokazatelja učinkovitosti Nacionalnog programa za rano otkrivanje raka dojke u Republici Hrvatskoj. U izradi rada su korišteni anonimizirani podaci žena odazvanih na mamografiju u prva tri ciklusa programa probira. Metodologijom povezivanja podataka s Registrom za rak ukupno je otkriveno 789 žena s intervalnim rakom i 3530 žena s rakom iz probira. Razlika između sudionica s rakom otkrivenim u probiru i sudionica s intervalnim rakom je modelirana upotrebom multivarijatne logističke regresije. Logističkim modelom za diskriminaciju između sudionica s rakom u probiru i sudionica s intervalnim rakom kao statistički značajne unutar modela (P≤0,05) identificirane su varijable: gustoća tkiva dojke (P=0,038), hormonalna nadomjesna terapija (P=0,034), te pozitivna anamneza o raku dojke u krvnih srodnica (P<0,001). Premda model možemo smatrati slabijim predviđajućim testom, što je u skladu sa sustavnim pregledom prethodnih modela predviđanja rizika za rak dojke, prednost modela jest da se temelji na podacima iz stvarnog svijeta, strogo je poštovan vremenski kriterij za intervalni rak, a tri ciklusa probira su razuman vremenski okvir za pojavu intervalnog raka. Model je najprikladniji za primjenu u hrvatskoj populaciji žena jer su u njoj identificirani čimbenici rizika za nastanak intervalnog raka, ali se uz prilagodbu može primijeniti i u drugim populacijama.

Abstract (english)

The goal of this study was to develop a model for predicting interval breast cancer as an indicator of the effectiveness of Croatia's National Breast Cancer Early Detection Program. The study used anonymized data from women who had mammograms throughout the first three cycles of the program. Data linking methodology to the Cancer Registry identified 789 women with interval and 3530 women with screen detected cancer. Multivariate logistic regression was used to model the differences between them. Three variables were found to be statistically significant in the model: breast tissue density (P=0.038), hormone replacement therapy (P=0.034) and a positive history of breast cancer in blood relatives (P<0.001). Although the model can be considered a weaker predictive test, which is consistent with a systematic review of previous breast cancer risk prediction models, the model's advantage is that it is based on real-world data, strictly adhering to the interval cancer time criterion, and using three screening cycles, which is an adequate time frame for interval cancer incidence. The model is best suited for usage in the Croatian female population because risk factors for the occurrence of interval cancer have been identified, but it can be applied to other populations with adaptations.

• Keywords: Žena; Rano otkrivanje raka; Hrvatska; Neoplazme dojke; Učestalost; Faktori rizika; Registri; Nadomjesna hormonska terapija
• Keywords (english): Female; Early Detection of Cancer; Croatia; Breast Neoplasms; Incidence; Risk Factors; Registries; Hormone Replacement Therapy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:687932
• Promotion: 2024
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 150 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-06-25 11:30:33