Is your glass half full or half empty? Around 50% of bowel cancer is related to lifestyle – most notably eating too much red and processed meat, drinking too much alcohol, consuming too many calories, taking too little fibre and not doing enough physical activity. Excess body weight is an important cause too – especially in men. Around 50% of the disease is due to other causes – genetics, environment, unknowns.
My glass is definitely half full! I get excited by the idea that we can – here and now – do something to cut bowel cancer risk if we get the right policies to support healthy eating, access and support for more physical activity, and incentives to cut our alcohol intake and body weight. Whilst we wait for those policies to happen we can also cut disease risk by lifestyle change.
Firstly, taking part in screening programmes is the most widespread action that can be taken by the over 50’s. Important for everyone – but especially those at high risk (for example those who have an adenoma found on screening) – changing lifestyles can make an impact on those influences that will affect the likelihood of developing new adenomas, cancer recurrence and possible interval cancers.
The BeWEL study of lifestyle change in overweight people who had an adenoma  (which I worked on at the Centre for Research into Cancer Prevention and Screening, University of Dundee) showed that over one year, significant changes in body weight, diet and activity habits could be achieved. These results were the same, irrespective of social background (35% of participants were from the two lowest quintiles of deprivation) and were consistent with a recent Cochrane review  that reported that weight management programmes have the potential to reduce inequalities in obesity and DO NOT contribute to health inequalities. In our study, a significantly higher proportion of people from more deprived areas had never undertaken successful weight management before and we also found that men (74% of participants) responded well to the programme.
Incidentally, we also found that around half our participants either had or were at high risk of Type 2 diabetes  and we succeeded in lowering blood glucose. The BeWEL programme embraced not the worried well, but rather the worried unwell.
Healthy lifestyles are important for everyone, but support for people at higher risk of bowel cancer is especially important. For further information see https://www.wcrf-uk.org/uk/preventing-cancer/cancer-types/bowel-cancer.
- Anderson AS, Craigie A, Caswell S, Treweek S, Stead M, Macleod M, Daly F, Belch J, Rodger J, Kirk A, Ludbrook A, Rauchhaus P, Norwood P, Thompson J, Wardle J, Steele RJC (2014) The impact of a body weight and Physical Activity weight loss intervention (BeWEL) initiated through a national colorectal cancer screening programme. BMJ;348:g1823 Available from: http://www.bmj.com/content/348/bmj.g1823 doi: 10.1136/bmj.g1823
- Bambra CL, Hillier FC, Cairns JM, Kasim A, Moore HJ, Summerbell CD (2015) How effective are interventions at reducing socioeconomic inequalities in obesity among children and adults? Two systematic reviews. Southampton (UK): NIHR Journals Library; Jan. (Public Health Research, No. 3.1.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK273911/ doi: 10.3310/phr03010
- Steele RJ, Anderson AS, Macleod M, Craigie AM, Caswell S, Belch J, Treweek S; The BeWEL team (2015) Colorectal adenomas and diabetes : implications for disease prevention Colorectal Dis. Jul;17(7):589-944 Available from: https://www.ncbi.nlm.nih.gov/pubmed/25581207 doi: 10.1111/codi.12895
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