BackgroundColorectal cancer (CRC) may be reduced by healthy lifestyle behaviours. We determined the extent of self-reported lifestyle changes in people at increased risk of CRC, and the association of these reports with anxiety, risk and knowledge-based variables.MethodsWe randomly selected 250 participants who had undergone surveillance colonoscopy for family history of CRC. A telephone interview was conducted, recording demographics and family history. Self-reported lifestyle change due to thoughts about CRC across a range of dietary and lifestyle variables was assessed on a four-point scale. Participants’ perceptions of the following were recorded: risk factor knowledge, personal risk, and worry due to family history. General anxiety was assessed using the GAD-7 scale. Ordinal logistic regression was used to calculate adjusted results.ResultsThere were 148 participants (69% response). 79.7% reported at least one healthy change. Change in diet and physical activity were most frequently reported (fiber, 63%; fruit and vegetables, 54%; red meat, 47%; physical activity, 45%), with consumption of tobacco, alcohol, and body weight less likely (tobacco, 25%; alcohol, 26%; weight 31%). People were more likely to report healthy change with lower levels of generalized anxiety, higher worry due to family history, or greater perceived knowledge of CRC risk factors. Risk perception and risk due to family history were not associated with healthy changes.ConclusionsSelf-reported lifestyle changes due to thoughts about CRC were common. Lower general anxiety levels, worries due to family history, and perceived knowledge of risk factors may stimulate healthy changes.
no clear evidence that spot positivity was different in the spring/ summer months compared with autumn/winter. Conclusion Seasonal variation did not appear to account for the fluctuations in spot positivity observed. We conducted a sub-group analysis restricted to 60 year-olds to explore the possibility that changes in the demographics of participants over time might affect the positivity patterns, but the data yielded similar inconsistencies. It is unlikely that operational factors account for the fluctuations as the BCSP ensures rigorous monitoring of test kit batches and quality control in the laboratories. More work is required to explore these data further in search of an explanation. Methods The gFOBt kits used by the BCSP have six windows (three pairs) lined with guaiac-impregnated philtre paper. The screening participant is asked to apply two faecal samples from three separate stools. The samples usually arrive dry at the laboratory, which is likely to reduce the degree of haemoglobin (Hb) degradation and provide the best opportunity to detect bleeding. BCSP policy is that every kit is logged on the day of receipt and read as soon as possible thereafter. BCSP Southern Hub data from the Bowel Cancer Screening System (BCSS) for 01/2008-07/2012 were analysed for subjects aged 60-69 years completing the first prevalent round of screening. The interval between each sample date and the date the sample was analysed (elapsed time) was calculated. Spot positivity was assessed by elapsed time, stratified by sex. Clinical outcomes were extracted from BCSS for subjects who had a positive gFOBt result. The relationship between positivity, elapsed time and clinical outcomes was examined. Results During the period of observation, nearly 1.2 million kits were returned to the Hub and 92% were read within five days of the last sample collection. For samples analysed one day after the last sample collection, spot positivity was 2.7% for women and 3.8% for men. Positivity declined thereafter until it reached a steady level at day 5 (women 1.3%; men 2.0%). Positivity for the most recently collected sample (usually spots 5 and 6) was slightly higher than for the spots collected earlier. There were 20,408 subjects (8,343 women; 12,065 men) who accepted further investigation. The outcome of those investigations was not associated with elapsed time between faecal sampling and test kit reading; the proportion of cancers, high-, intermediate-and low-risk adenomas was fairly constant as elapsed time increased. Conclusion The higher positivity associated with a shorter elapsed time did not appear to be associated with more false-positive tests. A number of factors may contribute to the pattern of positivity observed: (a) vegetable peroxidases present in the diet cause short term increases in gFOBt positivity; (b) faecal Hb denatures gradually before analysis, and (c) screening invitees worried about their health may return test kits more rapidly than others and a proportion of those individuals will be found to have colorectal cance...
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