Long-term lifestyle changes after colorectal cancer screening: randomised controlled trial

Abstract

NCT00119912.

Lifestyle changes at middle age and mortality: a population-based prospective cohort study

“…We evaluated that the control and the intervention (colorectal cancer screening) arms were not homogeneous and therefore should not be combined or compared. We based this on the significantly higher improvement of lifestyle in the control compared with the intervention arm,20 the effect of intervention on colorectal cancer mortality21 and the handling of the baseline lifestyle questionnaire in 2001, which was different between the arms. However, the associations between lifestyle changes and mortality in the intervention arm were partly similar but weaker as those in the control arm —for example, change from unfavourable to favourable versus remaining unfavourable was significantly protective in controls but not in screenees (HR 0.77, 95% CI 0.42 to 1.42).…”

“…The baseline questionnaire was handed to screening attendees at the screening centre while waiting for the examination, whereas it was mailed to the individuals in the control arm. Owing to this heterogeneity between the arms added by the findings that the screening intervention had impact on mortality and on the pattern of lifestyle changes,20 21 we here present results only from the control arm.…”

“…The one-page questionnaire was based on previous national surveys 23 24. Details of the questionnaire were reported in a previous paper 20. Briefly, lifestyle variables collected by the questionnaire were body height and weight (for calculation of body mass index, BMI, kg/m 2 ), current smoking status, frequency of physical exercise and frequency of consumption of selected food items.…”

“…The lifestyle score ranged from 0 to 4 points, indicating the number of lifestyle recommendations that the individual adhered to:20 normal body weight (BMI<25.0 kg/m 2 ),25 28 29 non-smoking,26 physical activity at least 20 min per day25 29 and a healthy diet. A healthy diet was classified as following these three dietary habits: (1) consumption of fruit, berries and vegetables with at least five courses per day,25 28 29 (2) consumption of fatty fish equivalent to at least once per week28 and (3) consumption of red and processed meat for dinner less than four times per week 27 29.…”

Ethical issues with colorectal cancer screening—a systematic review

“…There has also been a worry about CRC screening having a negative effect on lifestyle in general, because of health reassurance. It has also been pointed out that information about CRC and screening can cause anxiety, and anxiety with test results is reported…”