Patients with a personal or family history of cancer may have elevated risk of developing future cancers, which often remains unrecognized due to lapses in screening. This pilot study assessed the usability and clinical outcomes of a cancer risk stratification tool in a gynecologic oncology clinic. New gynecologic oncology patients were prompted to complete a commercially developed personal and family history-based risk stratification tool to assess eligibility for genetic testing using National Comprehensive Cancer Network criteria and estimated lifetime breast cancer risk using the Tyrer-Cuzick model. After use of the risk stratification tool, usability was assessed via completion rate and the System Usability Scale, and health literacy was assessed using the BRIEF Health Literacy Screening Tool. 130 patients were prompted to complete the risk stratification tool; 93 (72%) completed the tool. Race and ethnicity and insurance type were not associated with tool completion. The median System Usability Scale score was 83 out of 100 (interquartile range, 60–95). Health literacy positively correlated with perceived usability. Public insurance and race or ethnicity other than non-Hispanic White was associated with lower perceived usability. Sixty (65%) patients met eligibility criteria for genetic testing, and 21 (38% of 56 eligible patients) were candidates for enhanced breast cancer screening based on an estimated lifetime breast cancer risk of ≥20%. A majority of patients completed the digital cancer risk stratification tool. Older age, lower health literacy, public insurance, and race or ethnicity other than non-Hispanic White were associated with lower perceived tool usability.

中文翻译：

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数字癌症风险分层工具的集成和可用性，以优化对遗传性癌症风险患者的识别：一项试点研究

有癌症个人或家族史的患者未来罹患癌症的风险可能较高，但由于筛查失误，这种风险往往未被识别。这项试点研究评估了妇科肿瘤诊所癌症风险分层工具的可用性和临床结果。提示新的妇科肿瘤患者完成商业开发的基于个人和家族史的风险分层工具，以使用国家综合癌症网络标准评估基因检测的资格，并使用 Tyrer-Cuzick 模型估计终生乳腺癌风险。使用风险分层工具后，通过完成率和系统可用性量表评估可用性，并使用简要健康素养筛查工具评估健康素养。提示 130 名患者完成风险分层工具；93 人 (72%) 完成了该工具。种族和民族以及保险类型与工具完成度无关。系统可用性量表得分中位数为 83 分（满分 100 分）（四分位数范围，60-95）。健康素养与感知可用性呈正相关。公共保险和非西班牙裔白人以外的种族或民族与较低的可用性相关。60 名 (65%) 患者符合基因检测的资格标准，其中 21 名患者（56 名合格患者中的 38%）根据估计终生乳腺癌风险≥20% 成为增强乳腺癌筛查的候选者。大多数患者完成了数字癌症风险分层工具。年龄较大、健康素养较低、公共保险以及非西班牙裔白人以外的种族或民族与感知工具可用性较低有关。