Lifestyle Score, Decision Aid Affect Colon Cancer Prevention

Each of five healthy lifestyle choices decreases risk; screening decision aid not fully effective
By Lindsey Marcellin
HealthDay Reporter

WEDNESDAY, Oct. 27 (HealthDay News) -- Each additional healthy lifestyle behavior can decrease colorectal cancer risk by 11 percent, according to research published online Oct. 26 in BMJ. In another article in the same issue, a decision aid to help adults with low education levels make informed colorectal cancer screening decisions appears to cause more patients to avoid the screening entirely.

Helene Kirkegaard, Ph.D., of the Danish Cancer Society in Copenhagen, and colleagues conducted a prospective cohort study of 55,487 adults without cancer to assess their risk for colorectal cancer as related to their lifestyle index, a point system measuring adherence to five lifestyle recommendations (physical activity, waist circumference, smoking, alcohol intake, and diet; one point for each). For each additional point scored on the lifestyle index, the risk of colorectal cancer decreased by 11 percent, and the researchers concluded that nearly a quarter of all colorectal cancer cases could have been prevented if all the participants had the highest lifestyle index score.

In the second study, Sian K. Smith, Ph.D., of the University of Sydney in Australia, and colleagues studied adults with low educational and literacy levels to determine whether a simple patient decision aid could effectively support informed choice and involvement in decisions about colorectal cancer screening. Although the intervention group had higher knowledge levels afterward, they also had a significantly lower screening participation rate.

"Although the decision aid did not make people more worried about developing bowel cancer, it did make them feel less positive about screening, and reduced uptake of the screening test by 16 percent (75 percent in the control group versus 59 percent in the decision aid groups). It seems that this may have resulted from increasing their knowledge about the low personal benefit of screening," Smith and colleagues conclude.

Abstract - Kirkegaard
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Abstract - Smith
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