Design and implementation of an Internet-based cancer risk assessment tool: Use over 10 years.

Abstract

e13075 Background: Prevention and early intervention can improve survival and quality of life across all cancers. Patient understanding of risk factors, and associated actionable lifestyle changes and screening programs, is not well understood by clinicians. Methods: The Internet-based OncoLink “Reduce My Risk” tool was created in 2009 to provide information about cancer risk after individuals responded to a comprehensive survey regarding demographics and cancer risk factors. Research related to these data has been IRB-approved. Results: 28,001 surveys were submitted. Median age among respondents ≥18y was 26y (18-101). 60% were female, 87% lived in North America, and 76% were White/Non-Hispanic. 37% had at least a bachelor’s degree, and 22% had household income > $100,000/y; most lived in a city/suburb (81%). 13% were current smokers, 23% previous smokers, 10% used cigars or pipe tobacco (10%), 6% used oral snuff/chew/quid, and 29% reported secondhand smoke exposure. Other substance use included marijuana (22% former users, 10% current users), alcohol (52% current users, 8% of those ≥14 drinks/w), and areca nut, betel leaf, or exotic smoking (1%). BMI was ≥30 in 19%. 74% reported dietary risks and 36% infrequent exercise. Early intercourse and > 10 sexual partners were reported by 43% and 10%, respectively. Excess UV exposure was reported by 19%, and exposure to known carcinogens 14%; 1% were exposed to DES in utero, and < 1% took DES while pregnant. Nonmodifiable risk factors included family cancer history (64%) or genetic syndrome (3%), and cancer-predisposing health condition (26%). 31% of women began menstruating < 12y and 33% gave birth to a first child > 30y. Conclusions: This free, publicly accessible cancer risk assessment tool has a large user population with higher educational status, higher income, and smaller household than the general population. 97% of users report behaviors associated with cancer risk. Another 72% report non-modifiable risks. By understanding detailed characteristics of a large number of respondents, these data have the potential to answer many hypothesis-generating questions, with the ultimate goal of improving educational interventions to reduce cancer risk across the general public.