Abstract
Current evidence suggests that 30–50% of cancers are attributable to established lifestyle risk factors. Cancer-screening has been identified as an opportunity for delivering advice on lifestyle behaviour change for cancer prevention. This study aimed to evaluate the feasibility and acceptance of promoting advice on the latest evidence-based lifestyle recommendations for cancer prevention at the time of colorectal cancer screening at two hospitals in Lyon, France. This feasibility study included 49 patients (20 men and 29 women) who were invited for colonoscopy. Patients received a leaflet with lifestyle recommendations for cancer prevention, accompanied with a logbook to plan and monitor their behavioural changes. Feedback from patients, hospital staff, and researchers was received via evaluation questionnaires (n = 26) completed after testing the educational material for at least two weeks and via two focus group discussions (n = 7 and n = 9 respectively) organized at the end of the study. All interviewed patients were interested in lowering their cancer risk, and the majority felt ready to change their lifestyle (88%), although most did not know how to decrease their risk of cancer (61%). All patients found the educational material easy to understand and sufficiently attractive and 50% of the patients reported having achieved at least one of the healthy behaviours recommended within the two weeks following the intervention. All hospital staff and almost all patients (92%) involved found that the screening program and the visits planned for colonoscopy was an appropriate moment to provide them with the educational material. This feasibility study has shown that the content, paper-based format, and time of delivery of the intervention were adequate. Health professionals seem to be willing to provide lifestyle recommendations, and patients appear interested in receiving advice for lowering their cancer risk during screening visits.
Highlights
All patients who participated in the feasibility study were interested in lowering their Colorectal cancer (CRC) risk, most of them did not know how to decrease their risk (61%)
The necessity and importance of including lifestyle counselling as a part of CRC screening has been demonstrated in particular among individuals with a positive screening result, as they may be inclined to a less favourable lifestyle compared with those who tested negative at screening [17]. This feasibility study was set up to evaluate the feasibility of an intervention study aimed at delivering evidence-based lifestyle advice during CRC screening among individuals at higher CRC risk, as this may have high public health potential
Promoting healthy lifestyle advice to this population has the potential to reduce the risk of other related non-communicable diseases (NCDs). This intervention will shed light on changes in biomarkers relevant for cancer prevention, allowing a better understanding of the putative mechanisms involved. This feasibility study has shown that the content, paper-based format, and timing of delivery of the intervention were adequate and wellaccepted by both the health professionals and patients
Summary
Colorectal cancer (CRC) is the fourth most commonly diagnosed malignancy and the third leading cause of cancer death in the world, accounting for around 1.9 million new cases and almost 935,000 deaths in 2020 [1]. In France, for example, CRC is the second most common cancer and the second leading cause of cancer death, accounting for more than 48,061 new cases and 20,953 deaths in 2020 [1]. CRC is a complex disease with a number of recognised risk factors. Male sex, family history of CRC, inflammatory bowel disease, smoking, excessive alcohol drinking, overweight and obesity, low levels of physical activity and sedentary lifestyle, diabetes and high consumption of red and processed meat are established risk factors [4,5,6,7]. It has been estimated that lifestyle factors could account for up to 40% of CRC cases worldwide [8]
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