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PUBLIC HEALTH What's Your Cancer Risk?New Web Tool Assesses Personal Cancer Risk, Gives Prevention Information With a wealth of epidemiologic and genetic data becoming available, the development of a computer to tell you how long you can expect to live is a foreseeable possibility. So, too, is a computer that could tell you how to modify your behavior so you could live longer by a week, a year, or by decades. While such a computer might sound like a techno-character from a Michael Crichton plot line, the basis for such futurism went live last Wednesday when the Harvard Center for Cancer Prevention (HCCP) launched a new Web-based cancer risk assessment tool called Your Cancer Risk (www.yourcancerrisk.harvard.edu). Unlike the futuristic computer, the HCCP site does not predict an individual's total future health experience, but it does supply a questionnaire that ultimately allows visitors to assess their risk of acquiring four specific cancers: breast, colon, lung, and prostate. The personalized risk assessment gauge the site develops—measuring from low to high—inserts a bar where it determines a visitor's risk level is, based on the answers given. The site then allows a visitor to read about lifestyle and behavior tips that would reduce cancer risk. When clicking on such tips, the visitor can watch the bar on the personalized gauge drop to a more favorable level. "Your Cancer Risk gives people some personal idea of their cancer risk. It's at least as good as other clinical assessment tools used in doctors' offices," says David Hunter, professor of epidemiology and nutrition at the Harvard School of Public Health, head of HCCP, and one of several people who helped create the site. "It's also very much a teaching and communications exercise. By going through the questionnaire and seeing what the risk factors are and getting some personalized advice about how to reduce risk, I think people could learn a lot about specific cancer risk factors that aren't general knowledge." Graham Colditz, professor of epidemiology at HSPH, senior investigator on the Nurses' Health Study, and another of the site's primary developers, believes one of the system's key attributes is its ability to suggest that it is never too late to modify behavior. "The amount of time from behavior change to lower risk clearly varies, but for diseases such as colon cancer, adopting something as simple as screening habits—recommended by the site—has quick and substantial benefits. We hope the interactive features will encourage more people to modify their lifestyles," Colditz says. The algorithm that sifts through the weighted risk factors and personal information entered by visitors will be published in Cancer Causes and Control, an HCCP peer-reviewed journal. The algorithm was validated using information from the Health Professionals' Study, an HSPH-based study of 56,000 men. After creating a colon cancer risk index from this study, the HCCP team successfully tested the index against their Web tool, demonstrating the algorithm's reliability. The site is somewhat limited by age: it can only offer true risk assessments for those age 40 and older. This age constraint exists primarily because cancers found in younger age groups are most likely to be due to genetic predisposition, rather than long-term environmental exposures, making risk assessment much more difficult. —John Lacey |
