One-year impact of a large-scale pilot multimodal personalized early cancer detection and prevention program for individuals at high risk of cancers.

Abstract

10543 Background: The Interception program (IP) is a unique initiative aiming to assess the value of a dedicated personalized care pathway for individuals at high risk (HR) of different cancers. IP includes identification of HR individuals in primary care, a One-Day-Clinic (ODC) (including individual care and workshops aimed at information, education, awareness; informed prevention decisions on an evidence-based shared personalized early detection and prevention plan), implementing and monitoring this plan with community professionals and MyInterception digital follow-up. Methods: This prospective, cohort study analysed data from participants who entered IP between Jan 2021 and May 2023. Eligible participants were adults at high risk of breast ( > 2.5% at 5 yrs), lung ( > 1.6% at 5 yrs), prostate, pancreatic cancer, or Lynch syndrome. Data cut-off was June 2024. Primary endpoint was the 1-yr adherence rate to planned screening and risk-reduction measures (RRM), (the latter defined by full smoking cessation for smokers, or >1 point improvement of WCRF score for others (or stable if was >5 out of 7). Secondary endpoints were awareness of risk, screening and prevention measures, and cancer incidence. We assessed factors associated with 1-yr adherence to screening and RRM. Results: 719 participants were eligible for the present assessment, median age 50 (range 21-81), 80% female. 83% tertiary education, 38% active smokers, at HR of breast (360), lung (281), other (78) cancers. Median baseline WCRF score was 4 (range 0.5-7), 65% had a score < 5. At 1 yr, global adherence to both screening and RMM was 57%. Adherence to screening measures was between 82 and 100% overall. The 1-yr median WCRF score (N = 290) was 4.5 (range 1.25–7) (p = < 7.8e-07 vs baseline), 41% had improved ( > = 1 point) their score while 7.4% had remained stable >5. However, only 18% smokers succeeded in fully quitting smoking. The crude incidence of new cancer cases was 1.5%. We found major improvements in perceived knowledge and in the accuracy of self-estimated cancer risk scores 8 days after the ODC (p = < 2.2 e-16). In the multivariable logistic regression analysis, increasing age was associated with higher odds of global adherence (OR = 1.02 per year, 95% CI [1.001, 1.046], p = 0.03). Male sex was associated with a trend toward increased adherence (OR = 1.7, 95% CI [0.97, 3.15], p = 0.06). Smokers had significantly lower odds of adherence compared to other risk categories (OR = 0.17, 95% CI [0.09, 0.3], p < 0.0001). Among smokers, male sex was significantly associated with higher odds of adherence compared to female sex (OR = 2, 95% CI [1.1, 3.6], p = 0.01). Conclusions: IP demonstrated promising results in promoting cancer risk reduction and achieving satisfactory adherence to screening among HR individuals. However, challenges remain, particularly in enhancing adherence to RRM and reaching less educated populations.