e13119 Background: Pts having CA surgery have high information needs related to diagnosis, stage, and what caused their CA. Direct EMR access via web portals has grown, and offers a novel means to integrate supplemental health information into the e-chart, such as relevant genetic risk of CA. The AWARE trial (Advancing Web-based Medical Record Access and Risk Evaluation for Cancer Patients) studied the impact of providing personalized pathology (pPATH) and pers/fam history (PFHx) summaries enhanced with information about genetic CA risk and risk assessment. Methods: Peri-op CA pts completed baseline and 3-mo follow-up surveys. Pts randomized to enhanced (E) arm received pPATH & PFHx summaries with embedded tailored info about genetic CA risk and relevant high-risk features. Unenhanced (U) arm got pPATH & PFHx only. Use of summaries and 2 “Genetic risk: Learn more” links was tracked. Outcomes-Primary: awareness, knowledge (of genetic CA risk); Secondary: perceived risk, use of “Learn more” links, intentions/actions toward risk assessment--were stratified by genetic risk factors reported at baseline (0-1, 2+) & use of “Learn more” links. Results: 171 pts consented; men (p = 0.003) & non-White (p = 0.02) were more likely to decline the study. Overall 149 (87%) were randomized & eligible to use AWARE: 109 (73%) logged in, 120 (81%) completed follow-up. Predictors of AWARE use: White race (p < 0.05), sib w/CA (p < 0.05), and use intention (p = 0.005). Reporting 2+ genetic risk factors at baseline predicted use of pPATH, PFHx, and “Learn more” (all p < 0.001). Awareness increased overall (p < 0.002), but between arm changes in primary outcomes were not significant. E arm (vs U) was borderline more likely to seek risk assessment (32% v 18%, p = 0.09), with impact stronger in pts reporting baseline 0-1 (p = 0.035) vs 2+ risk factors (p = 0.7). Among E arm pts who used “Learn more” links, intentions (p = 0.054) & behaviors (p = 0.035) to seek risk assessment increased. Conclusions: AWARE increased genetic risk awareness overall, but primary outcomes were not met. Usage data and secondary outcomes highlight potential for EMR-based interventions to positively impact preventive behaviors toward genetic risk assessment.