PURPOSE: To assess the effectiveness of computerized familial risk assessment and tailored messages for identifying individuals for targeted cancer prevention strategies and motivating behavior change. METHODS: We conducted a randomized clinical trial in primary care patients aged 35-65 years using Family Healthware, a self-administered, internet-based tool that collects family history for six common diseases including breast cancer, colon cancer, and ovarian cancer, stratifies risk into three tiers, and provides tailored prevention messages. Cancer screening adherence and consultation were measured at baseline and 6-month follow-up. RESULTS: Of 3283 participants, 34% were at strong or moderate risk of at least one of the cancers. Family Healthware identified additional participants for whom earlier screening (colon cancer, 4.4%; breast cancer, women ages: 35-39 years, 9%) or genetic assessment (colon cancer, 2.5%; breast cancer, 10%; and ovarian cancer, 4%) may be indicated. Fewer than half were already adherent with risk-based screening. Screening adherence improved for all risk categories with no difference between intervention and control groups. Consultation with specialists did not differ between groups. CONCLUSION: Family Healthware identified patients for intensified cancer prevention. Engagement of clinicians and patients, integration with clinical decision support, and inclusion of nonfamilial risk factors may be necessary to achieve the full potential of computerized risk assessment.
PURPOSE: To assess the effectiveness of computerized familial risk assessment and tailored messages for identifying individuals for targeted cancer prevention strategies and motivating behavior change. METHODS: We conducted a randomized clinical trial in primary care patients aged 35-65 years using Family Healthware, a self-administered, internet-based tool that collects family history for six common diseases including breast cancer, colon cancer, and ovarian cancer, stratifies risk into three tiers, and provides tailored prevention messages. Cancer screening adherence and consultation were measured at baseline and 6-month follow-up. RESULTS: Of 3283 participants, 34% were at strong or moderate risk of at least one of the cancers. Family Healthware identified additional participants for whom earlier screening (colon cancer, 4.4%; breast cancer, women ages: 35-39 years, 9%) or genetic assessment (colon cancer, 2.5%; breast cancer, 10%; and ovarian cancer, 4%) may be indicated. Fewer than half were already adherent with risk-based screening. Screening adherence improved for all risk categories with no difference between intervention and control groups. Consultation with specialists did not differ between groups. CONCLUSION: Family Healthware identified patients for intensified cancer prevention. Engagement of clinicians and patients, integration with clinical decision support, and inclusion of nonfamilial risk factors may be necessary to achieve the full potential of computerized risk assessment.
Authors: Suzanne M O'Neill; June A Peters; Victor G Vogel; Eleanor Feingold; Wendy S Rubinstein Journal: Am J Med Genet C Semin Med Genet Date: 2006-11-15 Impact factor: 3.908
Authors: M H Gail; L A Brinton; D P Byar; D K Corle; S B Green; C Schairer; J J Mulvihill Journal: J Natl Cancer Inst Date: 1989-12-20 Impact factor: 13.506
Authors: P Watson; S A Narod; R Fodde; A Wagner; J F Lynch; S T Tinley; C L Snyder; S A Coronel; B Riley; Y Kinarsky; H T Lynch Journal: J Med Genet Date: 2003-08 Impact factor: 6.318
Authors: Ellen Warner; Donald B Plewes; Kimberley A Hill; Petrina A Causer; Judit T Zubovits; Roberta A Jong; Margaret R Cutrara; Gerrit DeBoer; Martin J Yaffe; Sandra J Messner; Wendy S Meschino; Cameron A Piron; Steven A Narod Journal: JAMA Date: 2004-09-15 Impact factor: 56.272
Authors: Jennifer L Moss; Siddhartha Roy; Chan Shen; Joie D Cooper; Robert P Lennon; Eugene J Lengerich; Alan Adelman; William Curry; Mack T Ruffin Journal: JAMA Netw Open Date: 2020-07-01
Authors: Simon Lucas Goede; Linda Rabeneck; Iris Lansdorp-Vogelaar; Ann G Zauber; Lawrence F Paszat; Jeffrey S Hoch; Jean H E Yong; Frank van Hees; Jill Tinmouth; Marjolein van Ballegooijen Journal: Int J Cancer Date: 2015-02-20 Impact factor: 7.396
Authors: Maya Leventer-Roberts; Ilan Gofer; Yuval Barak Corren; Ben Y Reis; Ran Balicer Journal: Eur J Public Health Date: 2020-04-01 Impact factor: 3.367
Authors: Adarsha S Bajracharya; Bradley H Crotty; Hollis B Kowoloff; Charles Safran; Warner V Slack Journal: J Am Med Inform Assoc Date: 2019-07-01 Impact factor: 4.497
Authors: Anita Y Kinney; Watcharaporn Boonyasiriwat; Scott T Walters; Lisa M Pappas; Antoinette M Stroup; Marc D Schwartz; Sandra L Edwards; Amy Rogers; Wendy K Kohlmann; Kenneth M Boucher; Sally W Vernon; Rebecca G Simmons; Jan T Lowery; Kristina Flores; Charles L Wiggins; Deirdre A Hill; Randall W Burt; Marc S Williams; John C Higginbotham Journal: J Clin Oncol Date: 2014-01-21 Impact factor: 44.544