Background: Most relatives of women with ovarian cancer are unaware of their increased risk for cancer and their eligibility for genetic counseling. State cancer registries offer a platform to communicate about inherited risk to this population. Methods: We conducted a two-arm randomized trial to test a theory-based communication intervention - Your Family Connects (YFC) - compared to the standard Georgia Cancer Registry (GCR) contact. A total of 1,938 eligible ovarian cancer survivors were randomly assigned to either the YFC arm (n=969) or the Standard Care arm (n=969). We assessed the number of ovarian cancer survivors and their close relatives who logged on to the study website by arm. Results: Survivor reach was significantly higher in the Standard Care arm than YFC (20.8% vs 15.2%, respectively; p<0.001). However, reach to relatives was limited to listed relatives in the YFC arm (n=20, 13.2%), with little participation from those in the Standard Care arm (n=1, 0.4%). Pooling across arms, minority race, longer time since diagnosis, and older age were all significantly associated with a decreased likelihood that the survivor accessed the website. Conclusions: The YFC intervention showed lower effectiveness for engaging survivors but was more effective than Standard Care in engaging at-risk relatives. Other factors (e.g., time since diagnosis) associated with lower reach must be considered in refining future outreach approaches. Impact: Partnering with a state cancer registry to foster family communication about inherited cancer risk is feasible. The possibility for broad population reach warrants further testing.

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