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Population-Targeted Risk Prediction to Guide Breast Cancer Screening in Cameroon

Award Number: F32CA257350
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS
PERIOD OF PERFORMANCE START DATE: 01/01/2021
PERIOD OF PERFORMANCE END DATE: 10/31/2022

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Population-Targeted Risk Prediction to Guide Breast Cancer Screening in Cameroon - Project Summary/Abstract: As cancer becomes an increasingly important cause of mortality in sub-Saharan Africa, nations must improve their capacity to diagnose and treat the malignancies that most affect their populations. Breast cancer is the most common cancer and cause of cancer-related mortality for women in Cameroon, where two thirds of patients present with stage III or IV disease, and five-year survival rates are less than 30%. A longstanding collaboration between the Cameroonian Ministry of Public Health, the University of Buea, and the University of California, Los Angeles (the MBLA partnership) plans to conduct key stakeholder interviews in order to assess the feasibility and acceptability of implementing a breast cancer screening program that is initially offered to high-risk women. Risk-based screening aims to equitably target early screening efforts while ensuring that diagnostic and treatment capacity are sufficient to manage lesions identified through screening. Such a program requires a breast cancer risk prediction model that is applicable and acceptable to Cameroonian women and feasible to evaluate through a community-based screening program. Studies in the United States, Asia, and Nigeria demonstrate that breast cancer risk prediction models perform best when they are ethnic group-specific, but no breast cancer risk prediction model has been developed for Cameroonian women. The African Breast Cancer case-control Study (ABCS) contains breast cancer risk factor information for women from Nigeria, Uganda, and a small subset of women from Cameroon. Traditional approaches to risk prediction will likely suffer from small sample size in models trained on Cameroon data only or from bias in models trained and validated on the full, ethnically diverse dataset. In Aim 1, a subgroup-specific cross-validation method will be incorporated into the Super Learner ensemble prediction algorithm to develop a breast cancer risk prediction model that incorporates all ABCS data but is optimized for Cameroonian women. Aim 2 addresses MBLA members’ concerns that certain risk factors from ABCS will be difficult to evaluate by community survey. Targeted learning methods will be used to define metrics for comparing risk prediction models including and excluding these variables so that Cameroonian stakeholders can evaluate whether to include these risk factors in their breast cancer risk prediction model. In Aim 3, an R shiny app will be developed, tested, and optimized in order to facilitate use of a Cameroon-specific breast cancer risk model in a future screening program. The methods developed and tested in this project could help to optimize cancer risk prediction models for other ethnic groups with limited data in sub-Saharan Africa and globally. This research will be conducted under the mentorship of the MBLA collaboration, UC Berkeley’s leaders in the field of targeted learning, and the UCSF Global Cancer Program. By providing protected time for training, research, and career development, this grant will facilitate the applicant’s progress towards becoming a breast surgical oncologist researching methods of improving access to cancer care in Africa.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = -$10,064 )
2023	2022	REGENTS OF THE UNIVERSITY OF CALIFORNIA, THE	1608 4TH ST STE 201	BERKELEY	CA	94710	ALAMEDA	USA	Cancer Research Manpower	000	2	1/27/2023	NON-COMPETING CONTINUATION	-$9,964
2023	2022	REGENTS OF THE UNIVERSITY OF CALIFORNIA, THE	1608 4TH ST STE 201	BERKELEY	CA	94710	ALAMEDA	USA	Cancer Research Manpower	001	2	8/30/2023	NON-COMPETING CONTINUATION	-$100
														Subtotal = -$10,064

Issue Date FY: 2022 ( Subtotal = $77,712 )
2022	2022	REGENTS OF THE UNIVERSITY OF CALIFORNIA, THE	1608 4TH ST STE 220	BERKELEY	CA	94710	ALAMEDA	USA	Cancer Research Manpower	000	2	12/16/2021	NON-COMPETING CONTINUATION	$68,478
2022	2022	REGENTS OF THE UNIVERSITY OF CALIFORNIA, THE	1608 4TH ST STE 201	BERKELEY	CA	94710	ALAMEDA	USA	Cancer Research Manpower	001	2	6/10/2022	NON-COMPETING CONTINUATION	$9,234
														Subtotal = $77,712

Issue Date FY: 2021 ( Subtotal = $76,436 )
2021	2021	REGENTS OF THE UNIVERSITY OF CALIFORNIA, THE	1608 4TH ST STE 220	BERKELEY	CA	94710	ALAMEDA	USA	Cancer Research Manpower	000	1	1/1/2021	NEW	$73,806
2021	2021	REGENTS OF THE UNIVERSITY OF CALIFORNIA, THE	1608 4TH ST STE 220	BERKELEY	CA	94710	ALAMEDA	USA	Cancer Research Manpower	003	1	7/12/2021	NEW	$1,478
2021	2021	REGENTS OF THE UNIVERSITY OF CALIFORNIA, THE	1608 4TH ST STE 220	BERKELEY	CA	94710	ALAMEDA	USA	Cancer Research Manpower	001	1	1/1/2021	NEW	$0
2021	2021	REGENTS OF THE UNIVERSITY OF CALIFORNIA, THE	1608 4TH ST STE 220	BERKELEY	CA	94710	ALAMEDA	USA	Cancer Research Manpower	002	1	2/1/2021	NEW	$1,152
														Subtotal = $76,436

Grand Total All Awards = $144,084

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Population-Targeted Risk Prediction to Guide Breast Cancer Screening in Cameroon

Award Number: F32CA257350

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

PERIOD OF PERFORMANCE START DATE: 01/01/2021

PERIOD OF PERFORMANCE END DATE: 10/31/2022

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