Development, validation and testing of comprehensive cancer risk assessment tool for Indian adults

Cancer burden is growing in India, where the early screening process is invasive as well as expensive. It generates the need for a non-invasive and less expensive screening tool. This study aimed to develop and validate a comprehensive cancer risk assessment tool to identify potential factors increasing the cancer risk that can be modified accordingly, well before cancer initiation. The study was conducted in two phases – firstly, questionnaire development based on the previous literature, and assessing for reliability and validation with 7 experts. Cronbach’s Alpha, Intraclass Coefficient (ICC), and Multirater Fleiss Kappa were used to check for reliability and content validity for validation using SPSS 27.0 version. Secondly, the questionnaire was tested among 767 general population was analyzed using Principal Component Analysis (PCA) and Confirmatory Factor Analysis (CFA) using JASP 0.17.0.0. The Comprehensive Cancer Risk Assessment Tool for Indian Adults (CRATI) comprises of 49-items, with the score range of 1-189. Item-Content Validity Index (I-CVI) of the tool was found to be 0.92, which shows excellent content validity. Cronbach’s alpha and Intraclass Correlation Coefficient (ICC) were found to be 0.76, both of which were at an acceptable level. The percentage of total variances in the tool was 67.4%. The CRATI serves as an instrument to identify risk factors for overall cancer and can be used as a primordial prevention strategy to reduce individuals’ cancer risk through personalized risk modification.