EPIDEMIOLOGY Recalibration of the Gail model for predicting invasive breast cancer risk in Spanish women: a population-based cohort study

Abstract The Gail model for predicting the absolute risk of invasive breast cancer has been validated extensively in US populations, but its performance in the international setting remains uncertain. We evaluated the predictive accuracy of the Gail model in 54,649 Spanish women aged 45–68 years who were free of breast cancer at the 1996–1998 baseline mammographic examination in the population-based Navarre Breast Cancer Screening Program. Incident cases of invasive breast cancer and competing deaths were ascertained until the end of 2005 (average follow-up of 7.7 years) through linkage with population-based cancer and mortality registries. The Gail model was tested for calibra-tion and discrimination in its original form and after recali-bration to the lower breast cancer incidence and risk factor prevalence in the study cohort, and compared through cross