Easy-to-Use Decision Aids for Improved Cancer Family History Collection and Use Among Oncology Practices

TO THEEDITOR:Recently,Woodetal 1 andLuetal 2 documented the underreporting of family history in patients with breast and colorectal cancer. Lu et al 2 lay out reasons and proposed that time has come to improve family history collection. We fully agree with this statement but believe that more needs to be done. In our opinion the primary barriers to overcome are improving not only the collection but also the interpretation of cancer family history. 3 We conclude from a recent randomized controlled trial (Dekker et al, submitted for publication) that education of clinicians does not improve the referral rate for genetic counseling of those at high risk. This led to our development of an easy-to-use digital referral test that guides clinicians and patients through appropriate family history collection and provides an instant conclusion regarding the presence or absence of an increased hereditary cancer risk. We also evaluated this referral test for usability. By using the referral test, nonmedical personnel gave the correct advice in 84% of patient cases, 4 whereas a group of doctors (general practitioners, ge