{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:16:42Z","timestamp":1787584602882,"version":"build-2736575974"},"reference-count":44,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n General mammography screening guidelines target women at average risk within a specified age range (age based) and do not consider absolute risk of individual women at a given age (risk based).<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare outcomes of mammography screening strategies that vary by 5-year risk of invasive breast cancer vs age-based strategies.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This decision analytical model used 2 established Cancer Intervention and Surveillance Modeling Network (CISNET) breast cancer models and simulated US women born in 1980 who were aged 40 years or older without a prior history of breast cancer. Modeling analyses were conducted from April 2023 to April 2025.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n Digital breast tomosynthesis delivered via 50 screening strategies (3 age based and 47 risk based) vs a no-screening scenario. Five-year absolute invasive breast cancer risk was based on the validated Breast Cancer Surveillance Consortium, version 3 calculator. Women\u2019s 5-year breast cancer risk was categorized as low, average, intermediate, or high.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Primary outcomes included lifetime number of breast cancer deaths averted and false-positive screening recalls. Lifetime outcomes were averaged across models and expressed per 1000 women screened.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Nine risk-based screening strategies were associated with a comparable or greater number of deaths averted than biennial age-based screening from ages 40 to 74 years (B40-74) (range across strategies for mean model estimates, 6.8-7.5 per 1000 women vs 6.8 per 1000 women) as well as reduced false-positive recalls by 8% to 23% (1050-1257 per 1000 women for risk-based screening strategies vs 1365 per 1000 women for B40-74). For example, a risk-based approach using a combination of biennial screening (for women at low risk aged 55-74 years, at average risk aged 50-59 years, at intermediate risk aged 45-54 years, and at high risk aged 40-49 years) and annual screening (for women at average risk aged 60-74 years, at intermediate risk aged 55-74 years, and at high risk aged 50-74 years) would be associated with 6% more breast cancer deaths averted than B40-74 (7.2 vs 6.8 per 1000 women) and 13% fewer false-positive recalls (1190 vs 1365 per 1000 women). Results were consistent across the 2 CISNET models, and the relative difference in breast cancer deaths averted between B40-74 and risk-based screening strategies was more pronounced than for life-years gained.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this decision analytical modeling study of breast cancer screening, population risk-based screening using 5-year invasive breast cancer risk was associated with similar or greater benefits than age-based screening as well as reduced false-positive recalls. As personalized medicine advances, risk-based screening is poised to become a cornerstone of breast cancer prevention, offering a more nuanced and tailored approach to patient care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.52944","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T16:00:28Z","timestamp":1768924828000},"page":"e2552944","source":"Crossref","is-referenced-by-count":6,"title":["Five-Year Absolute Risk\u2013Based and Age-Based Breast Cancer Screening in the US"],"prefix":"10.1001","volume":"9","author":[{"given":"Oguzhan","family":"Alagoz","sequence":"first","affiliation":[{"name":"Department of Industrial and Systems Engineering, University of Wisconsin\u2013Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Industrial and Systems Engineering, University of Wisconsin\u2013Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Gil Quessep","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC, University Medical Center Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"Kerlikowske","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California at San Francisco"},{"name":"Department of Epidemiology & Biostatistics, University of California at San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne S.","family":"Mandelblatt","sequence":"additional","affiliation":[{"name":"Department of Oncology, Georgetown University Medical Center, Georgetown University, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian L.","family":"Sprague","sequence":"additional","affiliation":[{"name":"Department of Surgery and the University of Vermont Cancer Center, Larner College of Medicine, University of Vermont, Burlington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Trentham-Dietz","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences and the Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin\u2013Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Hampton","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences and the Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin\u2013Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Groeneweg","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC, University Medical Center Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry J.","family":"de Koning","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC, University Medical Center Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana L.","family":"Miglioretti","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of California at Davis"},{"name":"Kaiser Permanente Washington Health Research Institute, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clyde B.","family":"Schechter","sequence":"additional","affiliation":[{"name":"Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolien T.","family":"van Ravesteyn","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC, University Medical Center Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna N. 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