Strategies for identifying and recruiting a racially/ethnically diverse group of women at high risk for breast cancer to a randomized controlled trial were evaluated. The trial was to evaluate interventions designed to increase chemoprevention uptake. These findings were published in Cancer Prevention Research.

Chemoprevention has been found to decrease the incidence of invasive breast cancer by 50% to 65% among women at high risk; however, uptake of chemoprevention remains low (approximately 15%). To evaluate whether strategies for recruiting these patients can be improved, high-risk women were identified for this trial between 2016 and 2020 at Columbia University Irving Medical Center using 5 strategies.

Strategy 1 was to identify women already enrolled in a study, strategy 2 was to identify women who were at high risk using data in their medical records, strategy 3 was to identify women with atypical hyperplasia or lobular carcinoma in situ diagnostic codes, strategy 4 was to encourage providers to refer high-risk patients, and strategy 5 was to recruit women through flyers and online advertisements.

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A total of 6229 women at high risk were identified by the study team, among them 58.8% were contacted, and among those contacted, 94.4% were eligible for enrollment. Ultimately, 300 (8.7%) women were successfully enrolled.

Among the eligible women, 16.3%, 37.8%, 15.0%, 29.3%, and 1.6% were identified using strategies 1 through 5, respectively. The women were mean age 58.7±9.7 years; however, age differed significantly by recruitment strategy. Women recruited via strategy 5 were younger, whereas those recruited via strategy 1 were older (47.4±8.8 vs 63.9±7.6). The racial/ethnic diversity was 47% non-Hispanic White, 15% non-Hispanic Black, 29% Hispanic, 5% Asian, and 20% other/unknown.

Among enrolled patients, most were recruited via strategy 4 (44.7%), through contact with their healthcare provider. Patients recruited with the other strategies were 27.2% via strategy 1, 11.7% via strategy 2, 10.3% via strategy 3, and 6.0% via strategy 5.

Women who did not enroll were older (P =.006), more were Hispanic or other ethnicities (P <.001), and they had lower 5-year cancer risk (P <.001).

“We were able to identify and successfully recruit a large cohort of racially/ethnically diverse high-risk women from multiple recruitment sources to a randomized controlled trial evaluating the web-based decision support tools,” the researchers concluded. These strategies could be used to more efficient identify high-risk women for chemoprevention trials and improve enrollment yields.


McGuinness JE, Bhatkhande G, Amenta J, et al. Strategies to identify and recruit women at high risk for breast cancer to a randomized controlled trial of web-based decision support tools. Cancer Prev Res. 2022;OF1-OF8. doi:10.1158/1940-6207.CAPR-21-0593