Purpose

To analyze interventions implemented at the time of colorectal cancer (CRC) screening, or among individuals who have previously undergone investigation for CRC, focused on reducing CRC risk through promotion of lifestyle behavior change. Additionally, this review evaluated to what extent such interventions apply behavior change techniques (BCTs) to achieve their objectives.

Methods

Five databases were systematically searched to identify randomized control trials seeking to reduce CRC risk through behavior change. Outcomes were changes in health-related lifestyle behaviors associated with CRC risk, including changes in dietary habits, body mass index, smoking behaviors, alcohol consumption, and physical activity. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using random effects models. BCT’s were coded from a published taxonomy of 93 techniques.

Results

Ten RCT’s met the inclusion criteria. Greater increase in fruit/vegetable consumption in the intervention group were observed with respect to the control (SMD 0.13, 95% CI 0.08 to 0.18; p < 0.001). Across fiber, alcohol, fat, red meat, and multivitamin consumption, and smoking behaviors, similar positive outcomes were observed (SMD 0.09–0.57 for all, p < 0.01). However, among physical activity and body mass index, no difference between the intervention groups compared with controls were observed. A median of 7.5 BCTs were applied across included interventions.

Conclusion

While magnitude of the observed effect sizes varied, they correspond to potentially important changes in lifestyle behaviors when considered on a population scale. Future interventions should identify avenues to maximize long-term engagement to promote sustained lifestyle behavior change.

中文翻译：

---

评估结直肠癌筛查时基于生活方式的行为改变干预措施的潜在影响

目的

为了分析在结直肠癌 (CRC) 筛查时或在之前接受过 CRC 检查的个体中实施的干预措施，重点是通过促进生活方式行为改变来降低 CRC 风险。此外，本次审查还评估了此类干预措施在多大程度上应用行为改变技术（BCT）来实现其目标。

方法

系统地检索了五个数据库，以确定旨在通过行为改变降低结直肠癌风险的随机对照试验。结果是与结直肠癌风险相关的健康相关生活方式行为的变化，包括饮食习惯、体重指数、吸烟行为、饮酒和体力活动的变化。使用随机效应模型汇总具有 95% 置信区间 (CI) 的标准化平均差 (SMD)。BCT 是根据已发布的 93 种技术分类法进行编码的。

结果

十项随机对照试验符合纳入标准。相对于对照组，干预组的水果/蔬菜消费量有更大的增加（SMD 0.13，95% CI 0.08 至 0.18；  p  < 0.001）。在纤维、酒精、脂肪、红肉和多种维生素的摄入以及吸烟行为方面，观察到了类似的积极结果（所有 SMD 为 0.09-0.57，p  < 0.01）。然而，在体力活动和体重指数方面，干预组与对照组之间没有观察到差异。所包含干预措施中应用的 BCT 中位数为 7.5。

结论

虽然观察到的效应大小各不相同，但在人口规模上考虑时，它们对应于生活方式行为的潜在重要变化。未来的干预措施应确定最大限度地长期参与的途径，以促进持续的生活方式行为改变。