Novel Interactive Tool for Breast and Ovarian Cancer Risk Assessment (Bright Pink Assess Your Risk): Development and Usability Study
BackgroundThe lifetime risk of breast and ovarian cancer is significantly higher among women with genetic susceptibility or a strong family history. However, current risk assessment tools and clinical practices may identify only 10% of asymptomatic carriers of susceptibility...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2022-02-01
|
| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2022/2/e29124 |
| _version_ | 1797735273712320512 |
|---|---|
| author | Elizabeth A Hibler Angela J Fought Kiarri N Kershaw Rebecca Molsberry Virginia Nowakowski Deborah Lindner |
| author_facet | Elizabeth A Hibler Angela J Fought Kiarri N Kershaw Rebecca Molsberry Virginia Nowakowski Deborah Lindner |
| author_sort | Elizabeth A Hibler |
| collection | DOAJ |
| description |
BackgroundThe lifetime risk of breast and ovarian cancer is significantly higher among women with genetic susceptibility or a strong family history. However, current risk assessment tools and clinical practices may identify only 10% of asymptomatic carriers of susceptibility genes. Bright Pink developed the Assess Your Risk (AYR) tool to estimate breast and ovarian cancer risk through a user-friendly, informative web-based quiz for risk assessment at the population level.
ObjectiveThis study aims to present the AYR tool, describe AYR users, and present evidence that AYR works as expected by comparing classification using the AYR tool with gold standard genetic testing guidelines.
MethodsThe AYR is a recently developed population-level risk assessment tool that includes 26 questions based on the National Comprehensive Cancer Network (NCCN) guidelines and factors from other commonly used risk assessment tools. We included all women who completed the AYR between November 2018 and January 2019, with the exception of self-reported cancer or no knowledge of family history. We compared AYR classifications with those that were independently created using NCCN criteria using measures of validity and the McNemar test.
ResultsThere were 143,657 AYR completions, and most participants were either at increased or average risk for breast cancer or ovarian cancer (137,315/143,657, 95.59%). Using our estimates of increased and average risk as the gold standard, based on the NCCN guidelines, we estimated the sensitivity and specificity for the AYR algorithm–generated risk categories as 100% and 89.9%, respectively (P<.001). The specificity improved when we considered the additional questions asked by the AYR to define increased risk, which were not examined by the NCCN criteria. By race, ethnicity, and age group; we found that the lowest observed specificity was for the Asian race (85.9%) and the 30 to 39 years age group (87.6%) for the AYR-generated categories compared with the NCCN criteria.
ConclusionsThese results demonstrate that Bright Pink’s AYR is an accurate tool for use by the general population to identify women at increased risk of breast and ovarian cancer. We plan to validate the tool longitudinally in future studies, including the impact of race, ethnicity, and age on breast and ovarian cancer risk assessment. |
| first_indexed | 2024-03-12T12:56:39Z |
| format | Article |
| id | doaj.art-8dd42b8accd846e2a864362ecc6f5cee |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-12T12:56:39Z |
| publishDate | 2022-02-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-8dd42b8accd846e2a864362ecc6f5cee2023-08-28T20:52:45ZengJMIR PublicationsJournal of Medical Internet Research1438-88712022-02-01242e2912410.2196/29124Novel Interactive Tool for Breast and Ovarian Cancer Risk Assessment (Bright Pink Assess Your Risk): Development and Usability StudyElizabeth A Hiblerhttps://orcid.org/0000-0003-2007-8713Angela J Foughthttps://orcid.org/0000-0002-7486-8596Kiarri N Kershawhttps://orcid.org/0000-0002-0063-6397Rebecca Molsberryhttps://orcid.org/0000-0002-9657-9963Virginia Nowakowskihttps://orcid.org/0000-0001-6432-1266Deborah Lindnerhttps://orcid.org/0000-0002-1360-9048 BackgroundThe lifetime risk of breast and ovarian cancer is significantly higher among women with genetic susceptibility or a strong family history. However, current risk assessment tools and clinical practices may identify only 10% of asymptomatic carriers of susceptibility genes. Bright Pink developed the Assess Your Risk (AYR) tool to estimate breast and ovarian cancer risk through a user-friendly, informative web-based quiz for risk assessment at the population level. ObjectiveThis study aims to present the AYR tool, describe AYR users, and present evidence that AYR works as expected by comparing classification using the AYR tool with gold standard genetic testing guidelines. MethodsThe AYR is a recently developed population-level risk assessment tool that includes 26 questions based on the National Comprehensive Cancer Network (NCCN) guidelines and factors from other commonly used risk assessment tools. We included all women who completed the AYR between November 2018 and January 2019, with the exception of self-reported cancer or no knowledge of family history. We compared AYR classifications with those that were independently created using NCCN criteria using measures of validity and the McNemar test. ResultsThere were 143,657 AYR completions, and most participants were either at increased or average risk for breast cancer or ovarian cancer (137,315/143,657, 95.59%). Using our estimates of increased and average risk as the gold standard, based on the NCCN guidelines, we estimated the sensitivity and specificity for the AYR algorithm–generated risk categories as 100% and 89.9%, respectively (P<.001). The specificity improved when we considered the additional questions asked by the AYR to define increased risk, which were not examined by the NCCN criteria. By race, ethnicity, and age group; we found that the lowest observed specificity was for the Asian race (85.9%) and the 30 to 39 years age group (87.6%) for the AYR-generated categories compared with the NCCN criteria. ConclusionsThese results demonstrate that Bright Pink’s AYR is an accurate tool for use by the general population to identify women at increased risk of breast and ovarian cancer. We plan to validate the tool longitudinally in future studies, including the impact of race, ethnicity, and age on breast and ovarian cancer risk assessment.https://www.jmir.org/2022/2/e29124 |
| spellingShingle | Elizabeth A Hibler Angela J Fought Kiarri N Kershaw Rebecca Molsberry Virginia Nowakowski Deborah Lindner Novel Interactive Tool for Breast and Ovarian Cancer Risk Assessment (Bright Pink Assess Your Risk): Development and Usability Study Journal of Medical Internet Research |
| title | Novel Interactive Tool for Breast and Ovarian Cancer Risk Assessment (Bright Pink Assess Your Risk): Development and Usability Study |
| title_full | Novel Interactive Tool for Breast and Ovarian Cancer Risk Assessment (Bright Pink Assess Your Risk): Development and Usability Study |
| title_fullStr | Novel Interactive Tool for Breast and Ovarian Cancer Risk Assessment (Bright Pink Assess Your Risk): Development and Usability Study |
| title_full_unstemmed | Novel Interactive Tool for Breast and Ovarian Cancer Risk Assessment (Bright Pink Assess Your Risk): Development and Usability Study |
| title_short | Novel Interactive Tool for Breast and Ovarian Cancer Risk Assessment (Bright Pink Assess Your Risk): Development and Usability Study |
| title_sort | novel interactive tool for breast and ovarian cancer risk assessment bright pink assess your risk development and usability study |
| url | https://www.jmir.org/2022/2/e29124 |
| work_keys_str_mv | AT elizabethahibler novelinteractivetoolforbreastandovariancancerriskassessmentbrightpinkassessyourriskdevelopmentandusabilitystudy AT angelajfought novelinteractivetoolforbreastandovariancancerriskassessmentbrightpinkassessyourriskdevelopmentandusabilitystudy AT kiarrinkershaw novelinteractivetoolforbreastandovariancancerriskassessmentbrightpinkassessyourriskdevelopmentandusabilitystudy AT rebeccamolsberry novelinteractivetoolforbreastandovariancancerriskassessmentbrightpinkassessyourriskdevelopmentandusabilitystudy AT virginianowakowski novelinteractivetoolforbreastandovariancancerriskassessmentbrightpinkassessyourriskdevelopmentandusabilitystudy AT deborahlindner novelinteractivetoolforbreastandovariancancerriskassessmentbrightpinkassessyourriskdevelopmentandusabilitystudy |