Center's Website Targets Cancer By Risk Identification and Public Education
On January 19, the Harvard Center for Cancer Prevention took a giant step forward in the ongoing effort to get health information to the public when it unveiled the Your Cancer Risk website at www.yourcancerrisk.harvard.edu.
Graham Colditz, on left, chats with an HSPH community member as she uses the
Your Cancer Risk website to learn about her own risk for cancer.
Your Cancer Risk is an interactive site with two main components. One is a questionnaire that allows individuals to determine their risk for four types of cancer: breast, prostate, colon, and lung. The other component teaches users about cancer risk factors and how to lead lives that will lessen their chances of developing cancer.
The questionnaire covers topics of prior medical history, family history, screening history, and lifestyle factors like diet and exercise. Personalized levels of risk are then generated by an algorithm that compares the most current knowledge of cancer risks against the information provided by an individual. The risk is depicted by a colored bar graph.
What is innovative about the Your Cancer Risk site is not just that it allows custom-tailored risk assessments, but that it allows people to learn how to reduce their risk. "The Harvard Center for Cancer Prevention estimates that 50% of all cancer can be prevented when people take basic steps to reduce their risk," said Graham Colditz, director of education at the center. "Your Cancer Risk is unique because it offers people a road map, showing them which steps have the biggest impact on them."
Once a user has answered the questions and has seen his or her risk graph, the site offers specific tips for lowering the risk of cancer. The user can see how much the risk graph would drop if he or she adopted the advice. The site also provides information about how the user's answers determined his or her level of risk, both in positive and detrimental ways.
The algorithm that powers the risk assessment was developed by a Harvard working group that reviewed evidence to determine what factors have the strongest associations with cancer risk. In a pilot project looking only at risk of colon cancer, the algorithm was successfully tested by comparing expected results against actual cancer diagnoses among the 56,000 subjects in the Health Professionals Follow-Up Study.
The
Your Cancer Risk website is also being tested, this time by the Harvard
Vanguard HMO. This test, however, is not seeking validation, rather it
is examining various computer-based communication strategies to determine
how sites like Your Cancer Risk can be most effective. The site administrators
will revise the site as the Harvard Vanguard information is analyzed.
The Your Cancer Risk site provides useful information to the public, but the center's researchers caution that web-provided advice is not a substitute for a doctor's care. The site "empowers individuals to make risk-lowering changes outside of a clinical setting," said David Hunter, director of the center, "but we hope that healthcare professionals will be active partners in prevention. We'd like to see the website assist in medical decision making and encourage healthcare professionals to counsel patients on modifiable factors."
Marcello Pagano, professor of biostastistics and technology maven, commented "educating the public is an essential component of public health and this site goes a ways towards that."
Pagano said that "we've just scratched the surface" of using
the web as a public health tool and that we're likely to see more advances
along the lines of Your Cancer Risk in the coming years.
