Lifestyle predictors for inconsistent participation to fecal based colorectal cancer screening

Markus Dines Knudsen; Ane Sørlie Kvaerner; Edoardo Botteri; Øyvind Holme; Anette Hjartåker; Mingyang Song; Espen Thiis-Evensen; Kristin Ranheim Randel; Geir Hoff; Paula Berstad

doi:10.1186/s12885-022-09287-9

Lifestyle predictors for inconsistent participation to fecal based colorectal cancer screening

BMC Cancer. 2022 Feb 15;22(1):172. doi: 10.1186/s12885-022-09287-9.

Authors

Markus Dines Knudsen^{1

2

3}, Ane Sørlie Kvaerner⁴, Edoardo Botteri^{4

5}, Øyvind Holme^{6

7}, Anette Hjartåker⁸, Mingyang Song^{9

10

11

12}, Espen Thiis-Evensen¹³, Kristin Ranheim Randel⁴, Geir Hoff^{4

7

14}, Paula Berstad⁴

Affiliations

¹ Section for Colorectal Cancer Screening, Cancer Registry of Norway, P.O. Box 5313, 0304, Majorstuen, Oslo, Norway. markus.knudsen@kreftregisteret.no.
² Department of Transplantation Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Norwegian PSC Research Center, Oslo University Hospital, P.O. Box 4950, 0424, Rikshospitalet, Nydalen, Oslo, Norway. markus.knudsen@kreftregisteret.no.
³ Departments of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 02115, Boston, MA, USA. markus.knudsen@kreftregisteret.no.
⁴ Section for Colorectal Cancer Screening, Cancer Registry of Norway, P.O. Box 5313, 0304, Majorstuen, Oslo, Norway.
⁵ Department of Research, Cancer Registry of Norway, P.O. Box 5313, 0304, Majorstuen, Oslo, Norway.
⁶ Department of Medicine, Sørlandet Hospital Kristiansand, P.O. Box 416, 4604, Lundsiden, Kristiansand, Norway.
⁷ Department of Health Management and Health Economis, Institute of Health and Society, University of Oslo, P.O. Box 1089, 0317, Blindern, Oslo, Norway.
⁸ Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046, 0317, Blindern, Oslo, Norway.
⁹ Departments of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 02115, Boston, MA, USA.
¹⁰ Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, 02114, Boston, MA, USA.
¹¹ Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, 02114, Boston, MA, USA.
¹² Department of Nutrition, Harvard T.H. Chan School of Public Health, MA, Boston, USA.
¹³ Department of Transplantation Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Norwegian PSC Research Center, Oslo University Hospital, P.O. Box 4950, 0424, Rikshospitalet, Nydalen, Oslo, Norway.
¹⁴ Department of Research and Development, Telemark Hospital Trust, Ulefossvegen 55, 3710, Skien, Norway.

Abstract

Background: Consistent participation in colorectal cancer (CRC) screening with repeated fecal immunochemical test (FIT) is important for the success of the screening program. We investigated whether lifestyle risk factors for CRC were related to inconsistent participation in up to four rounds of FIT-screening.

Method: We included data from 3,051 individuals who participated in up to four FIT-screening rounds and returned a lifestyle questionnaire. Using logistic regression analyses, we estimated associations between smoking habits, body mass index (BMI), physical activity, alcohol consumption, diet and a healthy lifestyle score (from least favorable 0 to most favorable 5), and inconsistent participation (i.e. not participating in all rounds of eligible FIT screening invitations).

Results: Altogether 721 (24%) individuals were categorized as inconsistent participants Current smoking and BMI ≥30 kg/m² were associated with inconsistent participation; odds ratios (ORs) and 95% confidence intervals (CIs) were 1.54 (1.21-2.95) and 1.54 (1.20-1.97), respectively. A significant trend towards inconsistent participation by a lower healthy lifestyle score was observed (p < 0.05).

Conclusions: Lifestyle behaviors were associated with inconsistent participation in FIT-screening. Initiatives aimed at increasing participation rates among those with the unhealthiest lifestyle have a potential to improve the efficiency of screening.

MeSH terms

Adult
Alcohol Drinking / psychology
Body Mass Index
Colorectal Neoplasms / prevention & control*
Diet / psychology
Diet / statistics & numerical data
Early Detection of Cancer / psychology
Early Detection of Cancer / statistics & numerical data*
Exercise / psychology
Exercise / statistics & numerical data
Female
Healthy Lifestyle
Humans
Life Style*
Logistic Models
Male
Occult Blood
Odds Ratio
Patient Acceptance of Health Care / statistics & numerical data*
Program Evaluation
Risk Factors
Smoking / psychology
Surveys and Questionnaires

Grants and funding

2019070/Helse Sør-Øst RHF