Cluster randomised controlled trial of computer decision support for management of familial cancer in primary care

INTERVENTION: Intervention arm subjects: Patients approaching their GP or practice nurse with concerns about their family history of cancer will be given a family history questionnaire to take home to complete, and then return for a second appointment. At the second consultation the trained lead clinician will enter information supplied by the patient and the family history questionnaire into the GRAIDS software. The software will support discussions with the patient about their risk of cancer and subsequent management. Control arm subjects: Subjects in the control practices approaching their GP or practice nurse with concerns about familial cancer will have a normal consultation according to their GPs current practice. All subjects: Subjects who are referred to the Regional Genetics Clinic will be asked to complete the measure of Informed Decision Making (IDM) questionnaire. This request will come from the Clinic with their appointment letter. The subjects will be requested to return the completed questionnaire to the Study Team. Subjects in the intervention practices who are not referred to the Regional Genetics Clinic will be sent a measure of IDM questionnaire by the Study Team. Six months after they have returned the measure of IDM, the subjects will be sent a second measure of IDM to complete and return to the Study Team. Trial Principal Investigator: Professor Jon Emery CONDITION: Familial breast or colorectal cancer ; Cancer ; Family history of malignant neoplasm PRIMARY OUTCOME: 1. The number of times that the GRAIDS software is used in the GP practices; 2. The total number of referrals to secondary care about familial cancer and the proportion that meet regional referral criteria; 3. The cost per use of the software and the cost per appropriate referral SECONDARY OUTCOME: Not provided at time of registration INCLUSION CRITERIA: Patients approaching their General Prectitioner (GP) or practice nurse with concerns about their family history of cancer.