OBJECTIVE: Women with hereditary breast and ovarian cancer syndrome (HBOC) face a higher risk of earlier, more aggressive cancer. Because of HBOC's rarity, screening is recommended only for women with strong cancer family histories. However, most patients do not have accurate history available and struggle to understand genetic concepts. METHODS: Cancer in the Family, an online clinical decision support tool, calculated women's HBOC risk and promoted shared patient-provider decisions about screening. A pilot evaluation (n=9 providers, n=48 patients) assessed the tool's impact on knowledge, attitudes, and screening decisions. Patients used the tool before wellness exams and completed three surveys. Providers accessed the tool during exams, completed exam checklists, and completed four surveys. RESULTS: Patients entered complete family histories (67%), calculated personal risk (96%), and shared risk printouts with providers (65%). HBOC knowledge increased dramatically for patients and providers, and many patients (75%) perceived tool results as valid. The tool prompted patient-provider discussions about HBOC risk and cancer family history (88%). CONCLUSIONS: The tool was effective in increasing knowledge, collecting family history, and sparking patient-provider discussions about HBOC screening. PRACTICE IMPLICATIONS: Interactive tools can effectively communicate personalized risk and promote shared decisions, but they are not a substitute for patient-provider discussions.
OBJECTIVE:Women with hereditary breast and ovarian cancer syndrome (HBOC) face a higher risk of earlier, more aggressive cancer. Because of HBOC's rarity, screening is recommended only for women with strong cancer family histories. However, most patients do not have accurate history available and struggle to understand genetic concepts. METHODS:Cancer in the Family, an online clinical decision support tool, calculated women's HBOC risk and promoted shared patient-provider decisions about screening. A pilot evaluation (n=9 providers, n=48 patients) assessed the tool's impact on knowledge, attitudes, and screening decisions. Patients used the tool before wellness exams and completed three surveys. Providers accessed the tool during exams, completed exam checklists, and completed four surveys. RESULTS:Patients entered complete family histories (67%), calculated personal risk (96%), and shared risk printouts with providers (65%). HBOC knowledge increased dramatically for patients and providers, and many patients (75%) perceived tool results as valid. The tool prompted patient-provider discussions about HBOC risk and cancer family history (88%). CONCLUSIONS: The tool was effective in increasing knowledge, collecting family history, and sparking patient-provider discussions about HBOC screening. PRACTICE IMPLICATIONS: Interactive tools can effectively communicate personalized risk and promote shared decisions, but they are not a substitute for patient-provider discussions.
Authors: Natasha Buchanan Lunsford; Karena F Sapsis; Betsy Smither; Jennifer Reynolds; Ben Wilburn; Temeika Fairley Journal: J Womens Health (Larchmt) Date: 2017-05-04 Impact factor: 2.681
Authors: Robert A Bell; Haley McDermott; Tonya L Fancher; Michael J Green; Frank C Day; Michael S Wilkes Journal: J Gen Intern Med Date: 2014-12-02 Impact factor: 5.128
Authors: Julia E McGuinness; Meghna S Trivedi; Thomas Silverman; Awilda Marte; Jennie Mata; Rita Kukafka; Katherine D Crew Journal: Cancer Genet Date: 2019-04-24
Authors: Patricia Birch; S Adam; N Bansback; R R Coe; J Hicklin; A Lehman; K C Li; J M Friedman Journal: J Genet Couns Date: 2016-05-23 Impact factor: 2.537
Authors: Xuan Li; Ryan M Kahn; Noelani Wing; Zhen Ni Zhou; Andreas Ian Lackner; Hannah Krinsky; Nora Badiner; Rhea Fogla; Isabel Wolfe; Hannah Bergeron; Becky Baltich Nelson; Charlene Thomas; Paul J Christos; Ravi N Sharaf; Evelyn Cantillo; Kevin Holcomb; Eloise Chapman-Davis; Melissa K Frey Journal: JCO Clin Cancer Inform Date: 2021-06