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UBC Theses and Dissertations

Colorectal cancer and health behaviours: primary prevention, early detection, and improved survivorship Sweeney Magee, Molly


Background: Health behaviours play a pivotal role in the primary and secondary prevention of colorectal cancer (CRC), and are a modifiable determinant of survivorship in CRC patients. However, adherence to recommended health behaviours, including physical activity and healthy body mass index (BMI) maintenance, is sub-optimal. This dissertation contributes to the understanding of individual-level factors that influence CRC prevention-related behaviours, the impact of a CRC diagnosis on these behaviours, and how these behaviours might be improved in CRC survivors. Methods: Baseline data from the British Columbia Generations Project (BCGP) were used to examine adherence to World Cancer Research Fund (WCRF) recommendations for cancer prevention. These data were also combined with follow-up data, and cancer registry data, to examine longitudinally the impact of a diagnosis of cancer, CRC or otherwise, on a subset of these behaviours. Additionally, a systematic mixed studies review was conducted to synthesize available literature concerning behaviour change interventions in CRC survivors. Results: Overall adherence to WCRF recommendations was relatively high in the BCGP cohort, though it was markedly lower for diet-related behaviours. Some clustering of low adherence with other risk factors for CRC, such as low socioeconomic status, was identified. The longitudinal analysis found CRC was not predictive of significant change in two cancer prevention recommendations regarding alcohol consumption and BMI between baseline and follow-up. The systematic mixed studies review identified tentative evidence that behaviour change interventions can improve CRC survivor health behaviours, and that members of this group have clear preferences regarding intervention content. However, a paucity of available evidence and a tendency towards poor specification of intervention content was common. Conclusion: These results offer novel contributions regarding targets for future interventions and research to improve health behaviours in the general population and in CRC survivors. Further research is needed to ensure the design of any such interventions are grounded in theory and evidence, and informed by patient preferences and contextual considerations.

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