Table 4. Summary of changes made to the prototype CanRisk tool.

Area of concern	Setting	Changes made to later version
Differences in practice between the two settings	Both	The tool has now been split into a CanRisk Genetics version for use in the specialist genetics setting and a CanRisk Core version for use in primary care.
Lack of approval from regulatory body	Both	The final version of the tool will carry CE marking.
Lack of information on how to manage the risk	Primary care	CanRisk Core will include better signposting to relevant management options and provide links to relevant parts of the NICE guidance.
Difficult questions leading to discomfort (e.g. pregnancy and baby loss) or judgement (e.g. breastfeeding, alcohol intake and weight)	Both	Questions collecting data on factors that do not currently contribute to the risk model have been removed. A description of why other data are collected has been included in the FAQs.
Completing a detailed family history	Primary care	Collection of a limited family history (i.e. first/second degree relatives) will be required for CanRisk Core.
Lack of information about how the data required for the calculation were to be used and stored	Both	Enhanced information on the privacy policy has been included at registration. An additional embedded webpage called Privacy and Cookies has also been included with detailed information.
Need for training to use the tool effectively	Both	Following registration, users are taken to a quick start guide to familiarise themselves with the main functionality of the tool. In addition, an updated and searchable section of Frequently Asked Questions has been included.
Further training on genetic risk communication	Primary Care	The CanRisk Core version of the tool will include refined risk communication formats, enabling easier interpretation in the time-limited environment.