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Streamlining Inherited Cancer Identification via an EMR-Integrated Risk Assessment Platform: A Nonrandomized Clinical

Lori A Orlando1, Kathleen F Mittendorf2, Nathan A Bihlmeyer3

  • 1Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.

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|April 29, 2026
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Summary
This summary is machine-generated.

Integrating electronic medical record (EMR) tools for family health history (FHH) assessment significantly improves identification of patients at risk for inherited cancer syndromes, addressing a critical gap in current care.

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Area of Science:

  • Oncology
  • Genetics
  • Medical Informatics

Background:

  • Approximately 10% of cancers are linked to heritable germline variants.
  • Current methods for identifying at-risk individuals for inherited cancer syndromes are suboptimal.

Purpose of the Study:

  • To evaluate the feasibility of using electronic medical record (EMR)-integrated technology for personal and family health history (FHH) risk assessment.
  • To enhance the identification of patients at risk for a wide range of inherited cancer syndromes.

Main Methods:

  • A single-arm, nonrandomized clinical trial involving adult patients at Vanderbilt University Medical Center.
  • Utilized an EMR-integrated platform for self-reported personal and FHH collection to assess risk for 24 hereditary cancer syndromes.
  • 1685 patients were consented, with outcomes including platform completion rates and identification of individuals meeting genetic counseling criteria.

Main Results:

  • The risk assessment platform was completed by 57.5% of participants who started it.
  • Among completers, 28.5% met criteria for genetic counseling, with nearly half of these previously unidentified by billing codes.
  • Only 20.0% of those eligible for genetic counseling actually attended.

Conclusions:

  • A significant proportion of patients meet criteria for genetic counseling for inherited cancer syndromes, indicating a gap in current identification methods.
  • Integrating patient-facing FHH collection and assessment tools into primary care EMRs can improve inherited cancer risk identification.
  • Further enhancements to risk assessment processes and genetic counseling attendance are warranted.