“I think it’s really important that people keep signing up to these type of trials to push research forward.”
A study looking at lifestyle changes in people with pre cancerous bowel growths
This study looked at ways to change diet and increase physical activity in people who had a high risk polyp (adenoma) removed from their bowel.
More about this trial
One of the aims of the NHS Bowel Cancer Screening Programme is to spot early stage bowel cancer. The programme also looks for a type of high risk polyp called an adenoma. The doctor will remove any adenomas during a routine colonoscopy. This will stop it from going on to develop into bowel cancer. But they can grow back afterwards.
We know from research that there is strong evidence that a diet high in red and processed meat, and low levels of physical activity can cause bowel cancer.
In this study, the researchers looked for ways to change diet and exercise in people who had an adenoma removed from their bowel. The researchers hoped it would be possible to encourage these people to:
- cut down on eating red meat
- eat less processed meat
- increase their levels of exercise
The study was in 2 parts. In part 1, small focus groups, interviews and questionnaires helped researchers to find ways to change people’s behaviour.
In part 2, people were put into different diet and exercise groups.
Researchers looked at how people changed their lifestyle and if:
- they stuck to their new lifestyle plan
- how acceptable people found these suggestions
Summary of results
The study team found it was difficult to get enough people to take part in this research. This meant it was difficult to draw any firm conclusions.
The general findings were that many people:
- didn’t know much about the causes of colon cancer, for example, that a polyp is pre cancerous
- didn’t get information or advise about this
- weren’t prepared to change their lifestyle
The results of part 1 were published in 2012. The researchers organised small groups to find ways to help people to change their diet and increase their levels of exercise. The researchers hoped to use these findings in part 2 to introduce lifestyle change.
The main findings in part 1 were:
- people weren’t aware of the link with having an adenoma and bowel cancer
- most didn’t remember having information about this
- people’s diet and exercise levels were quite different, but most people weren’t motivated to change their lifestyle
- people weren’t aware how they should change their diet
The researchers didn’t publish these findings. They provided a detailed study report.
49 people joined part 2. The study team had hoped 200 people would take part, but a lot of people didn’t want to join. This was because they thought their diet and exercise levels were acceptable already or they weren’t prepared to change their diet.
49 people were put into 1 of 4 groups at random, and:
- 9 joined the exercise group – they increased their levels of physical activity (group 1)
- 10 joined the diet group - they cut out red and processed meat (group 2)
- 16 joined the exercise and diet group (group 3)
- 14 didn’t change anything
People in the diet and exercise groups had about 8 sessions to give them tips on how to change their diet and increase physical activity.
The researchers followed everyone up at:
- 3 months
- 6 months
- 12 months
At follow up, the group who didn’t change anything were eating more red meat and doing less exercise than the exercise and diet groups.
The study team found it was difficult to get enough people to join the study. Although the people who took part did change their lifestyle.
The researchers say it is important to tailor any lifestyle changes to the individual. They also say that people felt reassured after having an adenoma removed. But they should understand the importance of having an adenoma and the risks of bowel cancer. Increasing their knowledge might motivate them to change their lifestyle.
How to join a clinical trial
Professor Sue Wilson
NIHR Research for Patient Benefit (RfPB) Programme
NIHR Clinical Research Network: Cancer
University of Birmingham