Cancer risk estimation tools are used by clinicians to evaluate the risk of individuals who carry high-risk pathogenic variants. In this article, we propose a new competing risks model designed to provide personalized estimates of the risk of developing breast or ovarian cancer as the first event among women carrying pathogenic variants in the BRCA1 gene. Our approach incorporates both the personal and complete family history of cancer of these high-risk women and introduces some flexibly in the modeling of the dependence among members of the same family. We use a Gaussian copula with a correlation matrix expressed in terms of the kinship coefficients of pairs of members. Furthermore, we develop an iterative estimation algorithm to estimate the parameters of the underlying model in the presence of a selection bias inherent to the family recruitment process. The performance of the proposed method is evaluated through a simulation study. An application to the Breast Cancer Family Registry data highlights the ability of the model to provide personalized estimation of the risk of developing breast cancer or ovarian cancer as the first event within the competing risks framework.

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