# Project 1:Risk of cancer versus risk of cancer diagnosis? Accounting for diagnostic bias in predictions of breast cancer risk by race/ethnicity and breast density

> **NIH NIH U54** · NEW MEXICO STATE UNIVERSITY LAS CRUCES · 2020 · $68,667

## Abstract

Title: Risk of cancer versus risk of cancer diagnosis? Accounting for diagnostic bias in predictions of breast
 cancer risk by race/ethnicity and breast density
 Project Leaders: Charlotte Gard, NMSU; Ruth Etzioni, Fred Hutch
[The content of this pilot proposal is identical in the NMSU and Fred Hutch proposals]
PROJECT SUMMARY/ABSTRACT
Risk prediction modeling is critical for tailoring prevention and screening efforts and targeting cancer treatment.
In breast cancer, both race/ethnicity and breast density are included as risk factors in a widely used risk
prediction model from the Breast Cancer Surveillance Consortium (BCSC), an authoritative source of
information on breast cancer screening and outcomes across the U.S. Since the BCSC is a screened
population, variations in diagnostic intensity by race/ethnicity and breast density may have affected the relative
risks associated with these factors.
The broad objective of this pilot project is to develop an analytic approach to de-bias risk prediction models
developed in settings where screening and/or biopsy frequencies vary across key risk factors. This will require
decoupling the patterns of screening/biopsy from the underlying disease process. We propose to do this via a
combination of statistical and simulation modeling using data from the BCSC. The statistical model (Aim 1) will
establish the variations in screening and biopsy frequencies by race/ethnicity and breast density in the BCSC
population. The simulation model (Aim 2) will estimate the natural history (onset and preclinical duration) of
breast cancer by race/ethnicity and breast density. We will combine these models to determine (Aim 3)
whether the dependence of breast cancer risk on race/ethnicity and breast density would change if screening
and biopsy frequencies were similar across groups defined by these factors.
This pilot project will bring together New Mexico University investigators with deep expertise in risk prediction
using the BCSC and Fred Hutchinson investigators who are established leaders in cancer modeling. Its focus
on racial and ethnic disparities fits squarely within the mission of this U54 partnership. The proposed work has
the potential to greatly clarify our understanding of how breast cancer risk is modified by race/ethnicity and
breast density. Further, if results show that natural history modeling is helpful in addressing bias in risk
prediction models due to variations in screening practices, this could lead to a paradigm shift in risk prediction
modeling for cancer.

## Key facts

- **NIH application ID:** 10006796
- **Project number:** 5U54CA132383-13
- **Recipient organization:** NEW MEXICO STATE UNIVERSITY LAS CRUCES
- **Principal Investigator:** Charlotte C. Gard
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $68,667
- **Award type:** 5
- **Project period:** 2007-09-30 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10006796

## Citation

> US National Institutes of Health, RePORTER application 10006796, Project 1:Risk of cancer versus risk of cancer diagnosis? Accounting for diagnostic bias in predictions of breast cancer risk by race/ethnicity and breast density (5U54CA132383-13). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/10006796. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*