Recommendations for the Use of CanRisk for Tubo-Ovarian Cancer Risk Estimation: a Focus Group and Research and Development-modified Delphi-based Study.

CanRisk is a risk prediction tool used to estimate tubo-ovarian cancer risk. It is increasingly being used in clinical practice. However, guidelines regarding the use of the CanRisk tool in clinical practice are lacking. Therefore, we aim to identify recommendations for the use of CanRisk in clinical practice. First, we organized separate focus group interviews with clinical genetic healthcare providers, gynecologic-oncology healthcare providers, patients, and patient advocates to identify relevant themes and subthemes regarding the use of CanRisk. Subsequently, we followed a Research ANd Development-modified Delphi-based approach using a questionnaire round consisting of statements based on previously identified themes, followed by a consensus meeting. Statements with consensus were transferred into recommendations and sent for approval to all participants who completed the questionnaire. We identified 44 statements based on the focus group meetings. Consensus was reached on 19 statements, of which 17 were transferred to recommendations. They concerned CanRisk itself (n = 3), counseling (n = 4), indications for the use of CanRisk (n = 2), data entry into CanRisk (n = 3), decisions regarding risk-reducing surgery and CanRisk (n = 2), education (n = 1), and collaboration regarding CanRisk (n = 4). Recommendations included that clinical geneticists should use CanRisk and communicate results to the gynecologic oncologist. Furthermore, the CanRisk result should not be used as an absolute threshold for risk-reducing surgery eligibility. This research identified recommendations for the use of CanRisk in clinical practice to standardize and optimize tubo-ovarian cancer prevention. CanRisk was seen as a valuable addition to healthcare that should be used in a uniform manner.