Understanding the potential and challenges of adenoma treatment as a prevention opportunity: Insights from the BeWEL formative study

doi:10.1016/j.ypmed.2011.10.017

Preventive Medicine

Volume 54, Issue 1, 1 January 2012, Pages 97-103

https://doi.org/10.1016/j.ypmed.2011.10.017 Get rights and content

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Abstract

Objectives

To explore prevention opportunities presented by colorectal adenoma diagnosis and inform engagement strategies for the BeWEL study (body weight and physical activity lifestyle intervention for colorectal cancer screening participants who have undergone adenoma removal).

Methods

Qualitative study comprising 4 purposively sampled focus groups conducted in urban and rural areas in Tayside, Scotland, with different deprivation levels. Participants were men and women (n = 17) aged 50-74 with BMI > 25 kg/m² with removal of adenoma detected by colorectal cancer screening.

Results

Adenoma diagnosis presents both opportunities and challenges for prevention. Some patients perceived adenoma as minor and not sufficiently motivating to act as a ‘teachable moment’. Patients had low awareness of the relationship between adenoma and lifestyle factors, and received little information on prevention during screening and treatment. Consequently they interpreted post-treatment ‘all clear’ messages as validation of existing lifestyles, and did not see the relevance of prevention advice. Receptiveness increased when the association between lifestyle, adenoma recurrence and other illness was explained.

Conclusion

The study illustrates the value of exploratory research into patient understanding to improve communications and health services. Without unduly worrying patients, professionals should explain how to reduce risk of adenoma, cancer and other diseases, particularly through diet, physical activity and weight reduction.

Highlights

► Adenoma diagnosis presents opportunities and challenges for prevention. ► Screening patients did not appear to know that the polyps could be pre-cancerous. ► Awareness of the role of lifestyle in preventing adenoma recurrence was limited. ► Screening professionals should endorse adenoma prevention messages.

Keywords

Qualitative research

Focus groups

Cancer screening

Adenoma

Polyps

Lifestyle

Intervention

Prevention

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¹: Fax: + 44 1382 496452.

²: Fax: + 44 1786 467329.

³: The BeWEL team: Dr Annie S Anderson, Centre for Research into Cancer Prevention and Screening, University of Dundee, UK; Prof Jill JF Belch, Vascular & Inflammatory Diseases Research Unit, University of Dundee, UK; Dr Stephen Caswell, Centre for Research into Cancer Prevention and Screening, University of Dundee, UK; Dr Angela M Craigie, Centre for Research into Cancer Prevention and Screening, University of Dundee, UK; Dr Fergus Daly, Dental Health Services Research Unit, University of Dundee, UK; Dr Alison Kirk, Department of Sport, Culture & the Arts, University of Strathclyde, UK; Prof Anne Ludbrook, Health Economics Research Unit, University of Aberdeen, UK; Ms Jackie Rodger, Colorectal Surgery, Ninewells Hospital, NHS Tayside, UK; Ms Martine Stead, Institute for Social Marketing, University of Stirling and the Open University, UK; Prof Robert Steele, Department of Surgery and Molecular Oncology, University of Dundee, UK; Miss Joyce Thompson, Directorate of Public Health, Dundee, NHS Tayside, UK; Dr Shaun Treweek, Quality, Safety & Informatics Research Group, University of Dundee and Tayside Clinical Trials Unit, UK; Prof Jane Wardle, Department of Epidemiology and Public Health, University College London, UK.