Joint ABS-UKCGG-CanGene-CanVar consensus regarding the use of CanRisk in clinical practice
Olga Tsoulaki, Marc Tischkowitz, Antonis C. Antoniou, Hannah Musgrave, Gillian Rea, Ashu Gandhi, Karina Cox, Tracey Irvine, Sue Holcombe, Diana Eccles, Clare Turnbull, Ramsey Cutress, Meeting Attendees, Avgi Andreou, Abdul Badran, Marion Bartlett, Cheryl Berlin, Kathie Binysh, Paul Brennan, Ruth Cleaver, Gemma Corbett, Rosemarie Davidson, Bianca DeSouza, Rachel Evers, Lorenzo Ficorella, Suzannah Fitzgerald, Andrea Forman, Fiona J. Gilbert, Rochelle Gold, Steph Greville-Heygate, Sarah Hamilton, Carrie L. Hammond, Rachel Hart, Lara Hawkes, Jude Hayward, Debbie Holliday, Anthony Howell, Gillian Hutchison, Jacqui Jenkins, Rosalyn Jewell, Grace Kavanaugh, Zoe Kemp, Victoria Kiesel, Ajith Kumar, Fiona Lalloo, Zosia Miedzybrodzka, Jennie Murray, Sian Nisbet, Della Ogunleye, Anbalakan Paramasivam, Claire Searle, Adam Shaw, E. Sheridan, Lucy Side, Katherine R. Smith, Beverley Speight, William Teh, Eleanor Thorpe, Anna Whaite, Louise Wilkinson, Siobhan Wilkinson, Emma R. Woodward, Alice Youngs, Stephanie Archer, Helen Hanson
Abstract
BACKGROUND: The CanRisk tool, which operationalises the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) is used by Clinical Geneticists, Genetic Counsellors, Breast Oncologists, Surgeons and Family History Nurses for breast cancer risk assessments both nationally and internationally. There are currently no guidelines with respect to the day-to-day clinical application of CanRisk and differing inputs to the model can result in different recommendations for practice. METHODS: of May 2023, with the aim of establishing best practice guidelines. RESULTS: Using a pre-workshop survey followed by structured discussion and in-meeting polling, we achieved consensus for UK best practice in use of CanRisk in making recommendations for breast cancer surveillance, eligibility for genetic testing and the input of available information to undertake an individualised risk assessment. CONCLUSIONS: Whilst consensus recommendations were achieved, the meeting highlighted some of the barriers limiting the use of CanRisk in clinical practice and identified areas that require further work and collaboration with relevant national bodies and policy makers to incorporate wider use of CanRisk into routine breast cancer risk assessments.