MyDIETRISK-BCa: A rapid tool for breast cancer risk assessment based on Malaysian dietary intake pattern

Mohd Razif, Shahril and Sharifah Wajihah Wafa, Syed Saadun Tarek Wafa (2014) MyDIETRISK-BCa: A rapid tool for breast cancer risk assessment based on Malaysian dietary intake pattern. In: Nutrition Society of Malaysia 29th Annual Scientific Conference 2014, 03-04 June 2014, KL.

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Abstract

Invasive screening and diagnosis methods for breast cancer make even educated women to desert the procedure until there is a symptom, in which by the time would be late for treatment. Diet has been associated with breast cancer risk among Asian women compared to their counterparts in Western countries and should be used as a component of risk assessment strategies. Therefore, MyDIETRISK-BCa was developed and validated to rapidly classify individuals into high or low risk group for breast cancer based on Malaysian dietary intake pattern. This self-administered index has a total of 20 items comprises selected epidemiological risk factors and dietary factors related to breast cancer risk. Scores were assigned according to weightage of known Odds Ratios and cut off points were established using Receiver Operating Characteristics analysis with a higher score indicating lower risk of breast cancer. Face validity of MyDIETRISK-BCa was evaluated by health professionals (n=10) and breast cancer patients (n=10). Content validity showed good agreement with Malaysian Dietary Guidelines and WCRF/AICR recommendation for cancer prevention. This newly developed MyDIETRISK-BCa dietary screening tool was then tested among users (n=96). The results showed that MyDIETRISK-BCa has high reliability in terms of response accuracy for dietary components by 90% to 99% correct classification and a maximum of 10% gross misclassification when compared with reference method i.e. food frequency questionnaire. It also has good stability with Pearson correlation coefficient value of 0.873 and a high internal consistency with Cronbach’s alpha value of 0.871 in reliability assessment. Finally, MyDIETRISK-BCa was then tested for its validity in assessing breast cancer risk among 377 women undergoing standard initial diagnosis procedure for breast cancer i.e. fine needle aspiration cytology (FNAC) of the breast. Results showed that MyDIETRISK-BCa has good sensitivity (79-80%), specificity (85-91%), positive (66-83%) and negative (89-92%) predictive values and acceptable agreement (k=0.611-0.704) in assessing breast cancer risk besides demonstrating a high construct validity (p<0.001) in differentiating the high and low risk group for breast cancer risk. It also has a discriminative accuracy with ranges between 0.836 and 0.891. In the absence of non-invasive screening methods, MyDIETRISK-BCa offers a novel way to rapidly classify individuals into high or low risk group for breast cancer based on Malaysian dietary intake pattern. Besides, this tool can be used in the public health nutrition field for population monitoring, epidemiological research, evaluation of intervention and economic research.

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