Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 26, 2021
Date Accepted: Dec 2, 2021
Bright Pink Assess Your Risk™: a novel interactive tool for breast and ovarian cancer risk assessment
ABSTRACT
Background:
The lifetime risk of breast and ovarian cancer is significantly higher among women with genetic susceptibility or strong family history. However, current 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 online quiz.
Objective:
The objectives of this work are to present the AYR tool, describe the AYR users, and compare classification using the AYR tool to breast and ovarian cancer genetic testing guidelines.
Methods:
The AYR tool includes 26 questions based on the National Cancer Center Network (NCCN) guidelines and factors from other commonly used risk assessment tools. We included all women who completed AYR between November 2018 and January 2019 with the exception of self-reported cancer or no knowledge of family history. We conducted univariate analyses and compared the AYR tool to NCCN criteria using measures of validity along with McNemar's Test.
Results:
There were 143,657 AYR completions, and most participants were either at increased or average risk for breast cancer or ovarian cancer (95.6%). Using the NCCN guidelines as the gold standard, the estimated sensitivity and specificity for the AYR was 100% and 89.9%, respectively (McNemar’s p= <0.001). Specificity improved when considering the additional questions asked by the AYR. However, we did observe some variation by race-ethnicity and age group. We found the lowest observed specificity was for Asian race (85.9%) and the 30-39 year age group (87.6%) for the AYR compared to NCCN criteria.
Conclusions:
These results demonstrate that Bright Pink’s AYR is an accurate tool for identifying women at increased risk of breast and ovarian cancer. However, future studies should validate the tool longitudinally, considering the variation observed by race-ethnicity and age on breast and ovarian cancer risk assessment.
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