Chatbot Education Improved Cancer Risk Knowledge in Adolescents and Young Adults With Hereditary Cancer Predisposition

Adding an electronic chatbot-based tool to a cancer predisposition clinic visit improved knowledge of cancer risk before age 30 years among adolescents and young adults (AYAs) with hereditary cancer predisposition, without increasing distress, according to a randomized clinical trial published in JAMA Network Open.

The trial, conducted at 4 academic centers from December 2022 to May 2025, compared clinic visits alone with visits plus AYA Risk Information and Screening Education (AYA-RISE; NCT04323774). The tool provided syndrome-specific cancer risk and screening information through an interactive chat and resource pages. According to the investigators, no content was derived from generative artificial intelligence.

The trial randomized 106 AYAs aged 12 to 24 years (mean age, 18.3 years) with 1 of 9 hereditary cancer predisposition syndromes: 54 to the intervention and 52 to a clinic visit alone. For the primary outcome, accurate knowledge of cancer risk before age 30 years rose from 52% at baseline to 78% after the visit in the intervention group, compared with 38% and 37% in the control group (odds ratio [OR], 3.50; 95% CI, 1.45-9.19; P = .005).

Knowledge of lifetime cancer risk (OR, 2.15; 95% CI, 0.81-6.15) and of recommended screening (OR, 2.17; 95% CI, 0.85-5.59) directionally favored the intervention but did not differ significantly between groups. Distress thermometer scores showed a nonsignificant reduction with the intervention (β = −0.50; 95% CI, −1.09 to 0.08; P = .09), and change in illness uncertainty did not differ by group.

The authors noted that enrollment was revised down from an original target of 300 participants, that only 25% of approached AYAs enrolled, and that limited enrollment may have affected the results. They also cited possible expectancy bias because baseline surveys were completed after randomization, and a study population from academic centers that lacked racial and ethnic diversity. The trial was funded by the National Cancer Institute.

Source: Kamihara J, Cronin AM, Uno H, et al. Chatbot intervention and cancer risk knowledge in adolescents and young adults with cancer predisposition: a randomized clinical trial. JAMA Netw Open. 2026;9(10):e2635794. doi:10.1001/jamanetworkopen.2026.35794