Time to add cancer prevention interventions to cancer screening?

Results from the BeWEL study published online in the BMJ, show that people at higher risk of colorectal cancer participating in bowel screening are interested in lifestyle and can change diet, activity and body weight if given guidance and support. See http://www.bmj.com/content/348/bmj.g1823

Lifestyle interventions can improve health outcomes in patients at risk of colorectal cancer

Direct interventions in diet and physical activity among patients at risk of colorectal cancer can lead to significantly improved weight reduction, helping tackle a major risk factor for the disease, a new study led by the University of Dundee has shown.

Obesity is a recognised risk factor for colorectal and other cancers. Recent UK estimates on cancer preventability indicate that 47% of colorectal cancer can be prevented through attaining a healthy body weight, appropriate levels of physical activity and dietary fibre intake and reductions in red and processed meat and alcohol.

The BeWEL study led by the University of Dundee looked at whether interventions to encourage patients at increased risk for colorectal cancer to make a sustained effort to reduce weight and improve physical activity would have an impact on health measures.

The researchers who carried out the new study said it showed that significant and sustained weight loss, improvements in blood pressure and blood glucose as well as changes in diet and physical activity could be achieved over a one-year period through an intervention consisting of regular meetings with lifestyle counsellors and monthly phone calls.

This intervention resulted in an average weight loss of 3.50kg in the intervention group, 2.7kg greater than patients who were only given a weight loss booklet only.

The researchers say the findings show the importance of combining evidence-based cancer prevention messages with cancer screening programmes to deliver the strongest benefits to patients.

Results of the study have been published online by the British Medical Journal at http://www.bmj.com/content/348/bmj.g1823.

“Weight management programmes in secondary care are common in the context of diabetes but they do not feature in the cancer screening setting, despite the fact that obesity is a risk factor in colorectal and other cancers,” said Annie Anderson, Professor of Public Health Nutrition at the University of Dundee and lead author of the research paper.

“The potential for healthcare systems, including hospitals and clinic, to promote appropriate diet, physical activity and body weight is an area that is underdeveloped. The BeWEL study had a high response rate indicating that patients are interested in lifestyle change and over 90% of participants kept going in the trial for a one year period”.

“At Dundee we have been among the leaders in establishing a national bowel screening programme. This study shows that taking additional action in tandem with such a programme to work with patients on diet and activity can offer significant benefits to patients in terms of cancer prevention.”

The BeWEL study is supported by the National Prevention Research Institute, funded through the Medical Research Council.

The study involved researchers from the Universities of Dundee (lead), Stirling, Aberdeen, Strathclyde and London and four Scottish Health Boards (Tayside, Forth Valley, Ayrshire and Arran and Greater Glasgow and Clyde).