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DOI: 10.1055/a-2516-1757
Assessing the Effect of a Mobile Application on Cancer Risk Health Literacy: A Cross-Sectional Study Design
Funding None.

Abstract
Background The “cancer risk calculator” mobile application aims to inform patients about their personal risks of cancer and the risk factors influencing said risks. The present analysis examines the responses to a questionnaire submitted by oncology patients treated with radiotherapy or their family members.
Objective The primary objective was to determine the effect of the app on the user's awareness and potential habit changes related to cancer risk. Further, the study aimed to discern any relationships between respondent characteristics and their questionnaire responses.
Methods A total of 162 patients were included in the analysis. Each patient's dataset comprised gender, date of birth, entry date, respondent type, type of cancer, and responses to 12 application-related questions. Statistical methods such as multiple regression models were employed to identify any effects of the respondent's characteristics on their responses. Statistical significance was set at p < 0.05.
Results Responding to the survey questions, 67.1% of respondents found the application useful, and 63.4% reported learning something new. More than half (52.5%) indicated a willingness to change their habits based on the information provided. Respondents also indicated that they were surprised by the number of risk factors shaping their risks and the large influence of some of these risk factors. Variables such as breast cancer diagnosis (p = 0.044) and age (p = 0.049) influenced specific question responses.
Conclusion The “cancer risk calculator” app appears to have a significant utility in educating its users about cancer risk and potentially influencing habit change.
Keywords
cancer risk calculator - patient education - habit change - mobile application - cancer awareness - health literacyProtection of Human and Animal Subjects
All subjects signed an informed consent, as approved by the ethical committee of the CHU de Liège.
Publication History
Received: 14 November 2024
Accepted: 13 January 2025
Accepted Manuscript online:
15 January 2025
Article published online:
21 May 2025
© 2025. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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References
- 1 World Health Organization. . Cancer. Accessed 2022 at: https://www.who.int/news-room/fact-sheets/detail/cancer
- 2 Thiengwittayaporn S, Wattanapreechanon P, Sakon P. et al. Development of a mobile application to improve exercise accuracy and quality of life in knee osteoarthritis patients: a randomized controlled trial. Arch Orthop Trauma Surg 2023; 143 (02) 729-738
- 3 Buller DB, Borland R, Bettinghaus EP, Shane JH, Zimmerman DE. Randomized trial of a smartphone mobile application compared to text messaging to support smoking cessation. Telemed J E Health 2014; 20 (03) 206-214
- 4 Al Ansari FS, Alfayez A, Alsalman D. et al. Using mobile health applications to enhance physical activity in Saudi Arabia: a cross-sectional study on users' perceptions. Int Health 2023; 15 (01) 47-55
- 5 Berntsen E, Babic A. Cherry: mobile application for children with cancer. Stud Health Technol Inform 2013; 192: 1168
- 6 Graetz I, Hu X, Curry AN, Robles A, Vidal GA, Schwartzberg LS. Mobile application to support oncology patients during treatment on patient outcomes: Evidence from a randomized controlled trial. Cancer Med 2023; 12 (05) 6190-6199
- 7 Gopichandran L, Garg R, Chalga MS, Joshi P, Dhandapani M, Bhatnagar S. Development of mobile application-based system for improving medication adherence among cancer patients receiving palliative therapy. Indian J Palliat Care 2023; 29 (01) 51-56
- 8 Ruco A, Dossa F, Tinmouth J. et al. Social media and mHealth technology for cancer screening: systematic review and meta-analysis. J Med Internet Res 2021; 23 (07) e26759
- 9 Lamb LR, Baird GL, Roy IT, Choi PHS, Lehman CD, Miles RC. Are English-language online patient education materials related to breast cancer risk assessment understandable, readable, and actionable?. Breast 2022; 61: 29-34
- 10 Ahmed HG, Abboh EAA, Alnajib AMA. et al. Shared thoughts and practices on some modifiable cancer risk factors. Eur Rev Med Pharmacol Sci 2023; 27 (08) 3612-3621
- 11 Westerlinck P, Coucke P, Albert A. Development of a cancer risk model and mobile health application to inform the public about cancer risks and risk factors. Int J Med Inform 2024; 189: 105503
- 12 National Cancer Institute. [Online]. Surveillance, Epidemiology, and End Results (SEER) Program. Accessed 2021 at: https://seer.cancer.gov/
- 13 Centers for Disease Control and Prevention [Online]. National Program of Cancer Registries (NPCR). Accessed 2021 at: https://www.cdc.gov/cancer/npcr/
- 14 Food and Drug Administration [Online]. Mobile Medical Applications. Accessed 2021 at: https://www.fda.gov/medical-devices/digital-health-center-excellence/mobile-medical-applications
- 15 Zarcadoolas C, Pleasant A, Greer DS. Advancing Health Literacy: A Framework for Understanding and Action. Hoboken, NJ: John Wiley and Sons; 2012
- 16 CDC. Health Literacy. Accessed 2020 at https://www.cdc.gov/healthliteracy/learn/index.html
- 17 Institute of Medicine. Board on Population Health and Public Health Practice, and Roundtable on Health Literacy, Health Literacy, eHealth, and Communication: Putting the Consumer First: Workshop Summary. Washington, DC: National Academies Press; 2009. https://doi.org/10.17226/12474
- 18 Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 2011; 155 (02) 97-107
- 19 Westerlinck P, Coucke P. Review of interactive digital solutions improving health literacy of personal cancer risks in the general public. Int J Med Inform 2021; 154: 104564
- 20 Galvin AM, Garg A, Griner SB, Moore JD, Thompson EL. Health literacy correlates to HPV vaccination among us adults ages 27–45. J Cancer Educ 2023; 38 (01) 349-356
- 21 Poon PKM, Tam KW, Lam T. et al. Poor health literacy associated with stronger perceived barriers to breast cancer screening and overestimated breast cancer risk. Front Oncol 2023; 12: 1053698
- 22 Gansler T, Henley SJ, Stein K, Nehl EJ, Smigal C, Slaughter E. Sociodemographic determinants of cancer treatment health literacy. Cancer 2005; 104 (03) 653-660
- 23 Di Tosto G, Walker DM, Sieck CJ. et al. Examining the relationship between health literacy, health numeracy, and patient portal use. Appl Clin Inform 2022; 13 (03) 692-699
- 24 Zhang L, Jiang S. Examining the role of information behavior in linking cancer risk perception and cancer worry to cancer fatalism in China: cross-sectional survey study. J Med Internet Res 2024; 26: e49383
- 25 Silva BMC, Rodrigues JJPC, de la Torre Díez I, López-Coronado M, Saleem K. Mobile-health: a review of current state in 2015. J Biomed Inform 2015; 56: 265-272
- 26 Rathbone AL, Prescott J. The use of mobile apps and sms messaging as physical and mental health interventions: systematic review. J Med Internet Res 2017; 19 (08) e295
- 27 Payne HE, Lister C, West JH, Bernhardt JM. Behavioral functionality of mobile apps in health interventions: a systematic review of the literature. JMIR mHealth Uhealth 2015; 3 (01) e20
- 28 Jang I. A systematic review on mobile health applications' education program for patients taking oral anticoagulants. Int J Environ Res Public Health 2021; 18 (17) 8902
- 29 Basch E, Deal AM, Kris MG. et al. Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol 2016; 34 (06) 557-565
- 30 Klasnja P, Pratt W. Healthcare in the pocket: mapping the space of mobile-phone health interventions. J Biomed Inform 2012; 45 (01) 184-198
- 31 Duman-Lubberding S, van Uden-Kraan CF, Jansen F. et al. Feasibility of an ehealth application “oncokompas” to improve personalized survivorship cancer care. Support Care Cancer 2016; 24 (05) 2163-2171
- 32 Mirkovic J, Kaufman DR, Ruland CM. Supporting cancer patients in illness management: usability evaluation of a mobile app. JMIR mHealth Uhealth 2014; 2 (03) e33
- 33 Lana A, Faya-Ornia G, López ML. Impact of a web-based intervention supplemented with text messages to improve cancer prevention behaviors among adolescents: results from a randomized controlled trial. Prev Med 2014; 59: 54-59
- 34 Martin CK, Miller AC, Thomas DM, Champagne CM, Han H, Church T. Efficacy of smartloss, a smartphone-based weight loss intervention: results from a randomized controlled trial. Obesity (Silver Spring) 2015; 23 (05) 935-942
- 35 Salmani H, Ahmadi M, Shahrokhi N. The impact of mobile health on cancer screening: a systematic review. Cancer Inform 2020; 19: 1176935120954191
- 36 Anderson KM, Wilson PW, Odell PM, Kannel WB. An updated coronary risk profile. a statement for health professionals. Circulation 1991; 83 (01) 356-362
- 37 Eichler K, Puhan MA, Steurer J, Bachmann LM. Prediction of first coronary events with the Framingham score: a systematic review. Am Heart J 2007; 153 (05) 722-731 , 731.e1–731.e8
- 38 Gail MH, Brinton LA, Byar DP. et al. Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 1989; 81 (24) 1879-1886
- 39 “Breast Cancer Risk Assessment Tool,” Breast Cancer Risk Assessment Tool. Accessed June 22, 2023 at: https://www.cancer.gov/bcrisktool
- 40 Vaffis S, Whaley S, Axon DR. et al. Features of cancer mHealth apps and evidence for patient preferences: scoping literature review. JMIR Cancer 2023; 9: e37330
- 41 Richards R, Kinnersley P, Brain K, McCutchan G, Staffurth J, Wood F. Use of mobile devices to help cancer patients meet their information needs in non-inpatient settings: systematic review. JMIR mHealth Uhealth 2018; 6 (12) e10026
- 42 Lee M, Lee H, Kim Y. et al. Mobile app-based health promotion programs: a systematic review of the literature. Int J Environ Res Public Health 2018; 15 (12) 2838
- 43 Alhassan GN, Öztürk İ, Adedoyi NFF, Bekun FV. Telehealth as a panacea amidst global pandemic (COVID-19) in Africa. Düzce Tıp Fakültesi Derg 2021; 23 (Special Issue): 43-47
- 44 Alhassan GN, Bosnak AS, Hamurtekin E. Perceived satisfaction and outcomes from drug information center services provided with a telehealth approach. Niger J Clin Pract 2022; 25 (12) 2053-2061
- 45 Gonzalez S, Mora Hurtado AC, Syder NC, Rodman J, Elbuluk N. Perception of skin cancer risk and sun protective practices in individuals with vitiligo: a prospective international cross-sectional survey. Arch Dermatol Res 2024; 316 (05) 189
- 46 Abittan B, Pachtman S, Herman S, Indelicato J, Herman J. Perception of breast cancer risk in over 11,000 patients during routine mammography exam. J Cancer Educ 2020; 35 (04) 782-787
- 47 Lane S, Fitzsimmons E, Zelefksy A. et al. Assessing electronic health literacy at an urban academic hospital. Appl Clin Inform 2023; 14 (02) 365-373
- 48 Kerr J, Rosenberg D, Frank L. The role of the built environment in healthy aging. J Plann Lit 2012; 27 (01) 43-60