Making Sense of Cancer Risk Calculators on the Web
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Cancer risk calculators on the internet have the potential to provide users with valuable information about their individual cancer risk. However, the lack of oversight of these sites raises concerns about low quality and inconsistent information. These concerns led us to evaluate internet cancer risk calculators.
After a systematic search to find all cancer risk calculators on the internet, we reviewed the content of each site for information that users should seek to evaluate the quality of a website. We then examined the consistency of the breast cancer risk calculators by having 27 women complete 10 of the breast cancer risk calculators for themselves. We also completed the breast cancer risk calculators for a hypothetical high- and low-risk woman, and compared the output to Surveillance Epidemiology and End Results estimates for the average same-age and same-race woman.
Nineteen sites were found, 13 of which calculate breast cancer risk. Most sites do not provide the information users need to evaluate the legitimacy of a website. The breast cancer calculator sites vary in the risk factors they assess to calculate breast cancer risk, how they operationalize each risk factor and in the risk estimate they provide for the same individual.
Internet cancer risk calculators have the potential to provide a public health benefit by educating individuals about their risks and potentially encouraging preventive health behaviors. However, our evaluation of internet calculators revealed several problems that call into question the accuracy of the information that they provide. This may lead the users of these sites to make inappropriate medical decisions on the basis of misinformation.
- Viswanath K. Science and society: the communications revolution and cancer control. Nat Rev Cancer. 2005;5(10):828–35. CrossRef
- Armstrong K, Eisen A, Weber B. Assessing the risk of breast cancer. N Engl J Med. 2000;342(8):564–71. CrossRef
- Gail MH, Brinton LA, Byar DP, et al. Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst. 1989;81:1879–86. CrossRef
- Costantino JP, Gail MH, Pee D, et al. Validation studies for models projecting the risk of invasive and total breast cancer incidence. J Natl Cancer Inst. 1999;91(18):1541–8. CrossRef
- Bondy ML, Newman LA. Assessing breast cancer risk: evolution of the Gail Model. J Natl Cancer Inst. 2006;98(17):1172–3.
- Barlow WE, White E, Ballard-Barbash R, et al. Prospective breast cancer risk prediction model for women undergoing screening mammography. J Natl Cancer Inst. 2006;98(17):1204–14.
- Bach PB, Kattan MW, Thornquist MD, et al. Variations in lung cancer risk among smokers. J Natl Cancer Inst. 2003;95(6):470–8.
- Thompson IM, Ankerst DP, Chi C, et al. Assessing prostate cancer risk: results from the Prostate Cancer Prevention Trial. J Natl Cancer Inst. 2006;98(8):529–34. CrossRef
- Impicciatore P, Pandolfini C, Casella N, et al. Reliability of health information for the public on the World Wide Web: systematic survey of advice on managing fever in children at home. BMJ. 1997;314(7098):1875–9.
- Allen JW, Finch RJ, Coleman MG, et al. The poor quality of information about laparoscopy on the World Wide Web as indexed by popular search engines. Surg Endosc. 2002;16(1):170–2. CrossRef
- Eysenbach G, Powell J, Kuss O, et al. Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review. JAMA. 2002;287(20):2691–700. CrossRef
- McLeod S. The quality of medical information on the internet: a new public health concern. Arch Ophthalmol. 1998;116:1663–5.
- Benigeri M, Pluye P. Shortcomings of health information on the internet. Health Promot Int. 2003;18(4):381–6. CrossRef
- Theodosiou L, Green J. Emerging challenges in using health information from the internet. Adv Psychiatr Treat. 2003;9:387–96. CrossRef
- Robinson T, Patrick K, Eng T, et al. An evidence-based approach to enteractive health communication. J Am Med Assoc. 1998;280(14):1264–9. CrossRef
- Ademiluyi G, Rees CE, Sheard CE. Evaluating the reliability and validity of three tools to assess the quality of health information on the Internet. Patient Educ Couns. 2003;50(2):151–5.
- Ekman A, Hall P, Litton JE. Can we trust cancer information on the Internet?—a comparison of interactive cancer risk sites. Cancer Causes Control. 2005;16(6):765–72. CrossRef
- Freedman AN, Seminara D, Gail MH, et al. Cancer risk prediction models: a workshop on development, evaluation, and application. J Natl Cancer Inst. 2005;97(10):715–23.
- Berkey CS, Frazier AL, Gardner JD, et al. Adolescence and breast carcinoma risk. Cancer. 1999;85(11):2400–9. CrossRef
- Sweeney C, Blair CK, Anderson KE, et al. Risk factors for breast cancer in elderly women. Am J Epidemiol. 2004;160(9):868–75. CrossRef
- Lagiou A, Lagiou P, Vassilarou DS, et al. Comparison of age at first full-term pregnancy between women with breast cancer and women with benign breast diseases. Int J Cancer. 2003;107(5):817–21. CrossRef
- Helewa M, Levesque P, Provencher D, et al. Breast cancer, pregnancy, and breastfeeding. J Obstet Gynaecol Canada. 2002;24(2):164–80.
- Newcomb PA, Egan KM, Titus-Ernstoff L, et al. Lactation in relation to postmenopausal breast cancer. Am J Epidemiol. 1999;150(2):174–82.
- Silvera SA, Miller AB, Rohan TE. Oral contraceptive use and risk of breast cancer among women with a family history of breast cancer: a prospective cohort study. Cancer Causes Control. 2005;16(9):1059–63. CrossRef
- Grabrick DM, Hartmann LC, Cerhan J, et al. Risk of breast cancer with oral contraceptive use in women with a family history of breast cancer. JAMA. 2000;284(14):1791–8. CrossRef
- Pesch B, Ko Y, Brauch H, et al. Factors modifying the association between hormone-replacement therapy and breast cancer risk. Eur J Epidemiol. 2005;20(8):699–711. CrossRef
- Hartmann LC, Sellers TA, Frost MH, et al. Benign breast disease and the risk of breast cancer. N Engl J Med. 2005;353(3):229–37. CrossRef
- Malin AS, Qi D, Shu XO, et al. Intake of fruits, vegetables and selected micronutrients in relation to the risk of breast cancer. Int J Cancer. 2003;105(3):413–8. CrossRef
- Gandini S, Merzenich H, Robertson C, et al. Meta-analysis of studies on breast cancer risk and diet: the role of fruit and vegetable consumption and the intake of associated micronutrients. Eur J Cancer. 2000;36(5):636–46. CrossRef
- Rubinstein WS. Hereditary breast cancer in Jews. Familial Cancer. 2004;3(3–4):249–57. CrossRef
- Terry KL, Willett WC, Rich-Edwards JW, et al. Menstrual cycle characteristics and incidence of premenopausal breast cancer. Cancer Epidemiol Biomark Prev. 2005;14(6):1509–13. CrossRef
- Terry MB, Zhang FF, Kabat G, et al. Lifetime alcohol intake and breast cancer risk. Ann Epidemiol. 2006;16(3):230–40.
- National Cancer Institute. SEER cancer statistics review: 1973–1992. Maryland: National Cancer Institute; 1995.
- American Cancer Society. Statistics for 2007. http://www.cancer.org/docroot/STT/stt_0.asp. Cited May 29, 2007.
- Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625–38. CrossRef
- Ross JA, Parker E, Blair CK, et al. Body mass index and risk of leukemia in older women. Cancer Epidemiol Biomark Prev. 2004;13(11 Pt 1):1810–3.
- Gillois P, Colombet I, Dreau H, et al. A critical appraisal of the use of Internet for calculating cardiovascular risk. Proc AMIA Symp. 1999;775–9.
- Chen X, Siu LL. Impact of the media and the internet on oncology: survey of cancer patients and oncologists in Canada. J Clin Oncol. 2001;19(23):4291–7.
- HarrisInteractive. 4-County survey finds most cyberchondriacs believe online health care information is trustworthy, easy to find and understand. http://www.harrisinteractive.com/news/allnewsbydate.asp? NewsID=464; 2002.
- Fox S, Rainie L. Vital decisions. How Internet users decide what information to trust when they or their loved ones are sick. Pew Internet and American Life Project; May 22, 2002.
- NCI. Breast cancer risk assessment tool. Bethesda, MD: National Cancer Institute Office of Communications; 1998.
- Making Sense of Cancer Risk Calculators on the Web
Journal of General Internal Medicine
Volume 23, Issue 3 , pp 229-235
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- web risk calculators
- cancer risk
- breast cancer
- Industry Sectors
- Author Affiliations
- 1. Center for Community-Based Research, Dana-Farber Cancer Institute, 44 Binney St, LW 618, Boston, MA, 02115, USA
- 2. Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA
- 3. School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- 4. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
- 5. Abramson Cancer Center, University of Pennsylvania, School of Medicine, Philadelphia, PA, USA