This model, developed by scientists from the National Cancer Institute (NCI), part of the National Institutes of Health, is described in a paper that appeared online May 11, 2011, in the Journal of the National Cancer Institute.

NCI’s Breast Cancer Risk Assessment Tool (BCRAT), which estimates a woman’s risk of developing invasive breast cancer, is used to counsel women and to determine eligibility for breast cancer prevention trials. It is based on the Gail model, an algorithm that uses information about personal and family medical history to estimate a woman’s chances of developing breast cancer, during the next five years and over her lifetime. The BCRAT was initially based on data from white women but was later augmented with a new model for estimating risk in African-American women, called the CARE model. With the publication of this latest model, the BCRAT has been updated again to include the new algorithm, and a disclaimer about accuracy for APA women has been removed.

“The new model is the latest step in our ongoing effort to improve NCI’s Breast Cancer Risk Assessment Tool by updating it with newly obtained data for specific subgroups of the population,” said senior author Mitchell H. Gail, M.D., Ph.D., after whom the original model is named.

To develop the model, Gail and colleagues used data from the Asian American Breast Cancer Study (AABCS), combined with data from NCI’s Surveillance, Epidemiology, and End Results (SEER) program. The AABCS is a population-based study which included more than 1,500 APA women, 38 percent of whom had invasive breast cancer. The resulting algorithm was tested using data from approximately 4,000 APA women in the NIH Women’s Health Initiative, a study of health issues among postmenopausal women.

The factors included in the APA model are the same as those for the other models included in the BCRAT. They include age at first menstrual period, age at first live birth, number of first-degree relatives (mother, sisters, or daughters) who had breast cancer, and number of previous benign breast biopsy examinations. However, the weight of individual factors and the calculations used to assess the interactions of multiple factors have been adjusted.

The researchers compared the projections of the model, which they named after the AABCS, with those of the BCRAT. For most risk factor combinations, the BCRAT generated higher risk estimates for APA women than the AABCS model. Compared with the new model, the BCRAT overestimated risk for Chinese and Filipino women, and women in most other groups, but not for Hawaiian women, who have higher breast cancer incidence rates than white women. Overall, they found that the AABCS model more accurately predicted breast cancer risk for APA women.

Each year in the general population, there are about 93.7 new cases of breast cancer per 100,000 APA women, and 127.3 new cases per 100,000 non-Hispanic white women, according to SEER data. In a 2007 SEER study, researchers found that among APA subgroups, native Hawaiian women had the highest breast cancer incidence rates (175.8 per 100,000), followed by Japanese-Americans (126.5 per 100,000). For Chinese-Americans, the largest subgroup, there are approximately 77.6 new cases per 100,000 women.

The new model may overestimate risk for women who have recently immigrated to the United States from certain regions of Asia where breast cancer risk is low. Further, the tool may not be appropriate for women living outside the United States. Although the authors conclude that there is a need for additional validation studies on the model, they recommend that clinicians and researchers use the AABCS model instead of the previous model when counseling APA women about their risk for breast cancer and determining their eligibility for breast cancer prevention trials.

Like the other risk projection models, the AABCS should only be used in consultation with a physician. The models that make up the BCRAT, including the new AABCS model, are not appropriate for women who have a history of breast cancers, have received radiation treatments to the chest, or who are known to carry a mutation in one of the breast cancer susceptibility genes (BRCA1 and BRCA2).

To access the NCI’s Breast Cancer Risk Assessment Tool (BCRAT), please visit: http://www.cancer.gov/bcrisktool/

For more information about NCI’s Division of Cancer Epidemiology and Genetics, please visit: http://dceg.cancer.gov

To access the 2007 SEER study on incidence rates in the APA population, please visit: http://seer.cancer.gov/publications/apicancer/index.html

About the National Cancer Institute (NCI): NCI leads the National Cancer Program and the NIH effort to dramatically reduce the burden of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI Web site at www.cancer.gov or call NCI’s Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

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Farmville Addiction

Anyone with a Facebook account knows that Farmville is the latest unlikely hit, allowing users to design and operate their own cartoon farm complete with too cute livestock and the unlikely banana tree that still produces a crop every three days regardless of the snow on the ground.

With millions of players, the charming escapist guilty pleasure can quickly become an addicting habit. If you find youself addicted to Farmville, consider the following ways to break the cycle.

5. Don’t Start Playing

Probably the most unlikely solution, it nevertheless is true that abstinence is the only certain way to avoid fullblown Farmville addiction. But those cartoon cows are just too cute, so we’ll move on to…

4. Set a Timer

You don’t need to spend hours a day organizing your livestock and rearranging your orchards or crops. At its heart, Farmville is a beguilingly simple game. Set an egg timer, or an old fashioned kitchen alarm, and tear yourself away when the bell rings. If that doesn’t work, you can always…

3. Ask Your Friends For Help

In this age of TV shows like Intervention, there’s likely a whole host of family and friends who will be eager to stage a fun and melodramatic effort to help your Farmville addiction.

2. Get Addicted to Something Else

Facebook offers a whole host of other classic time sucking games for escapism purposes. Try a walker on the darker side with the silly Mafia Wars, or search for pirate gold in Treasure Madness.

All that is fine, but I’m betting the most surefire way to cure Farmville Addiction is surprisingly simple:

1. Visit A Real Farm

Somehow, cartoon animals seem a bit less appealing when you’re reminded that their real life counterparts require a bit more work than the occasional brushing. The stench of cow manure alone could easily be enough to shatter the illusion!

If you have tips for beating a Farmville addiction, leave a comment below!

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1. Tips to Prevent Internet Addiction

Internet Addiction

For now, I want to offer some tips to help prevent Internet addiction. Whether you use these for yourself or a “friend” who is addicted to the Internet (Farmville addiction anyone?)

ZenHabits – a very cool site, btw – has 8 Practical Tips to Cure Your Internet ADD (Attention Deficit Disorder.)

Offline Day. Try to cure your Internet Addiction by having, at least once a month, a “completely offline” day. From the time you wake up till the time you go to sleep, avoid any contact with the Internet. No PDA, no email, no IM, no blogs.

MentalHealth.net has a good primer on Internet addiction titled Introduction to Internet Addiction.

Mental health professionals are split as to whether or not Internet addiction is real. No one disputes that some people use the Internet in a compulsive manner even to a point where it interferes with their their ability to function at work and in social relationships. What is disputed is whether people can become addicted to the Internet itself, or rather to the stimulation and information that the web provides. The controversy surrounding Internet Addiction is precisely whether people become addicted to the net itself, or to the stimulation to be had via the net (such as online gambling, pornography or even simple communication with others via chat and bulletin boards.)

If you need a good look at the basics of Internet addiction that article should be able to help you.

If you need a more detailed and academic look at Internet addiction, there’s Internet Addiction Disorder: Causes, Symptoms,and Consequences by Jennifer Ferris. Not the most light reading, but if you’re interested in Internet addiction, it’s a good read.

And maybe it’s ironic that you’re looking up information on Internet addiction while using the Internet?

What are your thoughts? Are you addicted to the Internet? Do you know someone who is? How has it affected your life? Leave a comment below and let us know!

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