Abstract
BackgroundAround one third of breast cancers in post-menopausal women could be prevented by decreasing body fatness and alcohol intake and increasing physical activity. This study aimed to explore views and attitudes on lifestyle intervention approaches in order to inform the proposed content of a lifestyle intervention programme amongst women attending breast cancer screening.MethodsWomen attending breast cancer screening clinics in Dundee and Glasgow, were invited to participate in focus group discussions (FGD) by clinic staff. The groups were convened out with the clinic setting and moderated by an experienced researcher who attained brief details on socio-demographic background and audio-recorded the discussions. Data analysis was guided by the framework approach. The main topics of enquiry were: Understanding of risk of breast cancer and its prevention, views on engaging with a lifestyle intervention programme offered through breast cancer screening and programme design and content.ResultsThirty one women attended 5 focus groups. Participant ages ranged from 51 to 78 years and 38 % lived in the two most deprived quintiles of residential areas. Women were generally positive about being offered a programme at breast cancer screening but sceptical about lifestyle associated risk, citing genetics, bad luck and knowing women with breast cancer who led healthy lifestyles as reasons to query the importance of lifestyle. Engagement via clinic staff and delivery of the programme by lifestyle coaches out with the screening setting was viewed favourably. The importance of body weight, physical activity and alcohol consumption with disease was widely known although most were surprised at the association with breast cancer. They were particularly surprised about the role of alcohol and resistant to thinking about themselves having a problem. They expressed frustration that lifestyle guidance was often conflicting and divergent over time. The concept of focussing on small lifestyle changes, which were personalised, supported socially and appropriate to age and ability were welcomed.ConclusionsOffering access to a lifestyle programme through breast screening appears acceptable. Explaining the relevance of the target behaviours for breast cancer health, endorsing and utilising consistent messages and identifying personalised, mutually agreed, behaviour change goals provides a framework for programme development.
Highlights
Around one third of breast cancers in post-menopausal women could be prevented by decreasing body fatness and alcohol intake and increasing physical activity
It is estimated that 38 % of postmenopausal breast cancer could be prevented by increased physical activity and reductions in alcohol and body fatness [2]
Moderating weight gain in adult life through caloric adjustment and physical activity is likely to be of benefit for reduction in cancers related to these behaviours as well as other non-communicable diseases [4,5,6]
Summary
Around one third of breast cancers in post-menopausal women could be prevented by decreasing body fatness and alcohol intake and increasing physical activity. It is estimated that 38 % of postmenopausal breast cancer could be prevented by increased physical activity and reductions in alcohol and body fatness [2]. Moderating weight gain in adult life through caloric adjustment (including calories from alcoholic drinks as well as food and other drinks) and physical activity is likely to be of benefit for reduction in cancers related to these behaviours (notably colon cancer) as well as other non-communicable diseases [4,5,6]. It is notable that whilst high weight gain in midlife has been associated with an increased risk of breast cancer diagnosis before or at age 50 in women, [10] a recent meta-analysis has reported that adult weight gain was unrelated to cancers of the breast in premenopausal women
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