This article is more than 5 years old. Information may no longer be current.

Limited evidence of cancer risk assessment tools in primary care

A review of randomized controlled trials indicated that risk tools may increase intentions to have a cancer screening, according to findings published in the Annals of Family Medicine.

Jennifer Walker, MPH, PhD, department of general practice, Melbourne Medical School, Australia, and colleagues also reported that additional interventions may increase risk-appropriate screening behaviors.

The researchers used the PubMed, Cochrane and EMBASE databases to identify trials that assessed cancer risk tools in a primary care setting. The search yielded 989 studies, which Walker and colleagues narrowed down to 11 after review. The 11 studies evaluated seven risk assessment tools, including the Genetic Risk Assessment on the Internet with Decision Support and the Harvard Colorectal Cancer Risk Assessment Tool.

Results showed that cancer risk assessment tools demonstrated beneficial effects, such as increasing intentions to have a cancer screening, increasing patient knowledge and risk perception and changes in physical activity and diet. The tools were not found to increase cancer-related anxiety. Additionally, the cancer risk-assessment tools increased clinician confidence and were more successful when initiated by a patient who was concerned about family cancer history.

Walker and colleagues also reported that the effects on actual cancer-screening behavior was not clear.

"Risk tools may increase actual intentions to have cancer screening, but additional interventions at the clinician or system level may be needed to increase screening behavior," Walker and colleagues wrote. "The results support the use of dedicated staff to maximize implementation of the intervention. The incorporation of health economic evaluation to determine the most cost-effective approaches to delivering risk-stratified cancer screening in primary care, and the potential added cost-benefit of genomic profiling within these trials, will be important outcomes to measure in future trials." – by Chelsea Frajerman Pardes

Disclosures: The authors report no relevant financial disclosures.