In the AYA-RISE trial, the addition of an electronic chatbot–based communication tool to a cancer predisposition clinic visit improved knowledge of cancer risk by age 30 compared with the visit alone, without increasing psychological distress. The findings were published by Kamihara et al in JAMA Network Open.
“AYAs [adolescents and young adults] with hereditary cancer predisposition live under a threat of cancer,” the investigators wrote. “Combining human interaction in the clinic with personalized, accurate electronic information can support AYAs with cancer predisposition and other serious conditions.”
Study Details
Between December 20, 2022, and May 30, 2025, 106 AYAs aged 12 to 24 years (mean age = 18.3 years; 64% female) with one of nine hereditary cancer predisposition syndromes were enrolled at four U.S. institutions. Participants were randomly assigned to have either a cancer predisposition visit alone (control; n = 52) or a visit supplemented by an electronic chatbot–based cancer risk communication tool (intervention; n = 54).
The chatbot—AYA Risk Information and Screening Education—provided syndrome-specific information about cancer risk and recommended screening, along with resource pages containing chat summary content, age-based screening recommendations, guidance on talking with peers, links to support organizations, and coping and bereavement support. Baseline and follow-up surveys assessed changes in knowledge of cancer risk by age 30 and over the lifetime, knowledge of recommended screening, and psychological distress.
Knowledge of cancer risk was identified as the primary outcome. Secondary outcomes included knowledge of recommended screening and level of psychological distress.
Key Findings
At baseline, accurate knowledge of cancer risk by age 30 was reported in 38% of AYAs in the control group and 52% in the intervention group.
A total of 37% of AYAs in the control group and 78% in the intervention group had accurate knowledge following the clinic visit, which, according to the investigators, reflected a greater improvement in knowledge of cancer risk by age 30 with the chatbot (odds ratio [OR] = 3.50; P = .005). The intervention was also associated with numerically greater improvements in knowledge of recommended screening (OR = 2.17; P = .11) and reductions in distress (distress thermometer, β = −0.50; P = .09).
“The electronic chatbot–based tool provided information to supplement the information AYAs received in the clinic, increasing knowledge of short-term cancer risk without increasing distress,” the investigators concluded. “This chatbot-based communication tool offers promise that other electronic interventions, adapted to meet needs of AYAs and embedded in a clinical care model, can provide needed support and empowerment for those living with life-threatening conditions.”
Jennifer W. Mack, MD, MPH, of Dana-Farber Cancer Institute, Boston, is the corresponding author of the article in JAMA Network Open.
Disclosure: The study was funded by a grant from the National Cancer Institute. For full disclosures of the study authors, visit jamanetwork.com.
