Increasing awareness and knowledge of lifestyle recommendations for cancer prevention in Lynch syndrome carriers: Randomized controlled trial.

A Vrieling,M Hurks,E Gómez García,N Hoogerbrugge,A Visser,E Kampman,M Hoedjes

doi:10.1111/cge.13076

Abstract

Lynch syndrome (LS) mutation carriers may reduce their cancer risk by adhering to lifestyle recommendations for cancer prevention. This study tested the effect of providing LS mutation carriers with World Cancer Research Fund-the Netherlands (WCRF-NL) health promotion materials on awareness and knowledge of and adherence to these recommendations. In this randomized controlled trial (n = 226), the intervention group (n = 114) received WCRF-NL health promotion materials. All LS mutation carriers were asked to fill out questionnaires at 2 weeks before (baseline, T0) and at 2 weeks (T1) and 6 months (T2) after the intervention. Linear mixed models were performed on awareness (0-7) and knowledge (0-7) of the recommendations, and on the secondary outcomes, that is adherence, distress, cancer worry, and risk perception. Compared with the control group, the intervention group became significantly more aware (overall mean difference = 1.24; 95%CI = 0.82-1.67) and obtained significantly improved knowledge of the recommendations (overall mean difference = 1.65; 95%CI = 1.27-2.03). Differences were significantly larger for T1 (Pinteraction = .003 and ≤.001, respectively) but remained significant for T2. No effect on secondary outcomes was found. In conclusion, provision of WCRF-NL health promotion materials increases awareness and knowledge of lifestyle recommendations for cancer prevention among LS mutation carriers without causing additional distress, but does not affect adherence.

Highlights

Lynch syndrome (LS) is a dominantly inherited syndrome characterized by a high risk of colorectal cancer (CRC), endometrial cancer and other types of cancer relatively early in life.[1,2,3,4,5,6] Risk of developing CRC up to age 70 in LS is 22%-69%,1–4 as compared with 1%-5% in the general Western population.[7]
This study tested the effect of providing LS mutation carriers with World Cancer Research Fund-the Netherlands (WCRF-NL) health promotion materials on awareness and knowledge of and adherence to these recommendations
The awareness and knowledge of the WCRF/American Institute of Cancer Research (AICR) recommendations varied per recommendation, and was significantly higher for all recommendations in the intervention group compared with the control group at T1 (Table 4)

Summary

| INTRODUCTION

Lynch syndrome (LS) is a dominantly inherited syndrome characterized by a high risk of colorectal cancer (CRC), endometrial cancer and other types of cancer relatively early in life.[1,2,3,4,5,6] Risk of developing CRC up to age 70 in LS is 22%-69%,1–4 as compared with 1%-5% in the general Western population.[7]. Numerous studies have investigated the association between dietary intake and other lifestyle factors and sporadic CRC.[13] There is general agreement that smoking, higher body fatness, abdominal fatness, red meat and processed meat intake, and lower dietary fiber. We tested the effect of providing these WCRF-NL health promotion materials on adherence to these recommendations and on levels of distress, cancer worry and cancer risk perception

| Participants and study procedures

| RESULTS

| DISCUSSION AND CONCLUSIONS