Chatbot Intervention and Cancer Risk Knowledge in Adolescents and Young Adults With Cancer Predisposition

@article{kamihara2026chatbot,
  title = {{Chatbot Intervention and Cancer Risk Knowledge in Adolescents and Young Adults With Cancer Predisposition}},
  author = {Junne Kamihara and Angel M. Cronin and Hajime Uno and Miki Horiguchi and Lauren Fisher and Jaclyn Schienda and Rebecca Vanderwall and Moran Snir and Guy Snir and Emilie Simmons and Andrew Khalaj and Evan Goler and Kayla V. Hamilton and Christopher C. Porter and Bojana Pencheva and Joshua D. Schiffman and Luke D. Maese and Wendy K. Kohlmann and Tara O. Henderson and Judy E. Garber and Lisa R. Diller and Ami V. Desai and Soren Feola and Dejoix-Leigh Johnson and Stefania Marron Rodriguez and Jennie Vagher and Casey J. Mehrhoff and Sarah Savage and Jennifer Perry and Madi Glorioso and Nicolas Moyer and James L. Klosky and Huma Q. Rana and Jennifer W. Mack},
  journal = {JAMA Network Open},
  year = {2026},
  month = oct,
  doi = {10.1001/jamanetworkopen.2026.35794},
  url = {https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2854932},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Chatbot Intervention and Cancer Risk Knowledge in Adolescents and Young Adults With Cancer Predisposition
AU  - Junne Kamihara
AU  - Angel M. Cronin
AU  - Hajime Uno
AU  - Miki Horiguchi
AU  - Lauren Fisher
AU  - Jaclyn Schienda
AU  - Rebecca Vanderwall
AU  - Moran Snir
AU  - Guy Snir
AU  - Emilie Simmons
AU  - Andrew Khalaj
AU  - Evan Goler
AU  - Kayla V. Hamilton
AU  - Christopher C. Porter
AU  - Bojana Pencheva
AU  - Joshua D. Schiffman
AU  - Luke D. Maese
AU  - Wendy K. Kohlmann
AU  - Tara O. Henderson
AU  - Judy E. Garber
AU  - Lisa R. Diller
AU  - Ami V. Desai
AU  - Soren Feola
AU  - Dejoix-Leigh Johnson
AU  - Stefania Marron Rodriguez
AU  - Jennie Vagher
AU  - Casey J. Mehrhoff
AU  - Sarah Savage
AU  - Jennifer Perry
AU  - Madi Glorioso
AU  - Nicolas Moyer
AU  - James L. Klosky
AU  - Huma Q. Rana
AU  - Jennifer W. Mack
PY  - 2026
DA  - 2026/10/07
JO  - JAMA Network Open
DO  - 10.1001/jamanetworkopen.2026.35794
UR  - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2854932
AB  - Importance: Adolescents and young adults (AYAs) with hereditary cancer predisposition face high rates of lifetime cancer risk. Models to support their understanding of cancer risk have not been developed.  Objective: To assess the effect of an electronic chatbot-based cancer risk communication tool on AYAs’ understanding of cancer risk.  Design, Setting, and Participants: This randomized clinical trial was conducted at the Dana-Farber Cancer Institute, Emory University/Children’s Healthcare of Atlanta, University of Chicago, and University of Utah Huntsman Cancer Institute between December 20, 2022, and May 30, 2025 and compared cancer predisposition visits alone vs visits with an electronic chatbot-based cancer risk communication tool, AYA Risk Information and Screening Education, using baseline and follow-up surveys to assess changes in knowledge of cancer risk by age 30 years and over their lifetime, knowledge of recommended screening, and level of psychological distress. Eligible participants were English speakers aged 12 to 24 years, who had 1 of 9 hereditary cancer predisposition syndromes. The primary analysis was conducted according to the intention-to-treat principle. Data were analyzed from July 21 to September 3, 2025.  Intervention: Chatbot-based intervention with cancer risk and recommended screening information tailored to each syndrome. Additional links to resource pages with chat summary content (learn), recommended age-based screening (plan), guidance about talking with peers (share), links to support organizations (connect), and coping and bereavement support (grow).  Main Outcomes and Measures: The primary outcome was knowledge of cancer risk. The secondary outcomes were knowledge of recommended screening and level of psychological distress.  Results: Of 798 AYAs assessed, 106 AYAs were randomized and enrolled (54 to the intervention group and 52 to the control group). Participants’ mean (SD) age was 18.3 (SD, 3.9) years, and 64% (68 of 106) were girls or women. At baseline, 38% of AYAs (20 of 52) in the control group and 52% (28 of 54) of AYAs in the intervention group had accurate knowledge of cancer risk by age 30 years. Following the clinic visit, 37% (19 of 52) of AYAs in the control group and 78% (42 of 54) in the chatbot-based intervention group had accurate knowledge, reflecting greater improvement in knowledge of cancer risk by age 30 years (OR, 3.50; 95% CI, 1.45-9.19; P = .005). AYAs in the intervention group had non–statistically significant improvements in knowledge of recommended screening (OR, 2.17; 95% CI, 0.85-5.59; P = .11) and reductions in distress compared with AYAs in the control group (distress thermometer, β = −0.50; 95% CI, −1.09 to 0.08; P = .09).  Conclusions and Relevance: In this randomized clinical trial, use of a chatbot-based intervention combined with a cancer predisposition clinic visit improved knowledge of cancer risk by age 30 years over a clinic visit alone, without increasing distress. Combining human interaction in the clinic with personalized, accurate electronic information can support AYAs with cancer predisposition and other serious conditions.  Trial Registration: ClinicalTrials.gov Identifier: NCT04323774
SN  - 2574-3805
ER  -