iPrevent: an evidence-based tool to assess and manage breast cancer risk
A new web-based tool is available at https://www.petermac.org/iprevent to help women understand their personal breast cancer risk and then act on it. It is designed to be used collaboratively by women and their doctors. Women can use it at home, print the output, and bring it to a consultation for discussion.
AMS has been given permision to link to the tool from our Self Assessment Tools Are you at risk of cancer? page on breast cancer.
How Does iPrevent Work?
iPrevent asks women to first enter their family cancer history, lifestyle and reproductive risk factor information. Using that information, it then provides 10 year and residual life-time risk estimates; there are options to view these as pictograms or graphs. It then provides tailored estimates of the absolute risk reductions for relevant breast cancer prevention strategies, personalised lifestyle change suggestions, and tailored advice on breast cancer screening. Women can print out a summary to take to a medical consultation for discussion, and so the doctor can incorporate it into the woman's medical record.
What is the Evidence Base for iPrevent?
iPrevent uses the well-validated IBIS and BOADICEA algorithms to estimate each woman's personal risk of breast cancer. An international prospective validation study, conducted using data on over 16,000 women, has confirmed the accuracy of the risk estimates provided. It uses Cancer Australia guidelines to determine which risk management options women are advised about, based on their risk level. An Australian pilot study of women and clinicians has also demonstrated that iPrevent has high usability and acceptability, and suggested that it improves knowledge without increasing anxiety. More detail on iPrevent peer-reviewed publications can be found by clicking the "Information For Clinicians" button on the iPrevent front page.
How Might Doctors Use iPrevent?
Focus groups conducted with doctors suggest that GPs will find iPrevent particularly useful for identifying the 1% of Australian women who are at high risk of breast cancer (>3 x population risk) and who may need onward referral. It is also useful for identifying the 4% of Australian women who are at moderate risk (1.5 – 3 x population risk) and for whom targeted lifestyle change, intensified breast cancer screening and risk-reducing medication should be considered. The "Information For Clinicians" page provides links to "Tips" pages that can help clinicians with the logistics of prescribing risk-reducing medication. Lastly iPrevent was also considered to have value in helping GPs to reassure women who are at average risk for breast cancer and thus avoid unnecessary onward referral.
How Was iPrevent Developed?
iPrevent was developed by a multidisciplinary team of experts with representation from general practice, Breast Cancer Network Australia consumers, genetics, breast surgical and medical oncology, psychooncology, sociology, epidemiology and computer science. It was an iterative process that included a formal needs assessment of all the potential end-user groups, software programming and a software verification study, piloting with women and clinicians, and final revision of the prototype to the current version released for free public use. The project was funded by the National Health and Medical Research Council, the National Breast Cancer Foundation and Breast Cancer Trials.
Content created April 2018