Many cancer cases—like other chronic diseases—are the result of an unhealthy lifestyle and could therefore be avoided. But it is an enormous challenge to change established routines and to permanently modify one’s preventive behavior. A willingness to change often only occurs when certain events force people to think about their own health. The occurrence of cancer in the family could be such an event—and thus be used for cancer prevention. This was concluded by a study conducted under the direction of Ulrike Haug, Professor of Clinical Epidemiology and Pharmacoepidemiology at the University of Bremen and Head of the Department of Clinical Epidemiology at BIPS.
“Relatives of cancer patients were particularly motivated to quit smoking, do more exercise, eat more fruit and vegetables and drink less alcohol—especially those who were aware of their increased cancer risk,” says Ulrike Haug. “The finding suggests high potential for prevention counselling, which could be used by doctors, for example, to help these people achieve a healthier lifestyle. Cancer prevention is particularly important for close relatives of cancer patients, as their risk of developing cancer themselves is increased due to genetic factors, amongst others.”
In the study, about 1,000 people from Germany filled out an online questionnaire. The study participants included 700 people with one or more first-degree relatives (i.e., children, siblings and parents) suffering from cancer and—as controls—300 people without cancer cases in close family members. The cancer types included in the study were colorectal, lung, prostate, breast, gastric, uterine, and cervical cancers.
Among other things, information on the individual lifestyle (smoking, physical activity, alcohol consumption, meat and fruit consumption) was requested. In addition, participants were asked to indicate on a multi-level scale how they assessed their own cancer risk and to indicate for every lifestyle factor if they were willing to change it.
“The results revealed distinct differences in the perception of one’s own cancer risk between the two groups,” says Ulrike Haug. For example, only 4% of those without cancer in close relatives thought that their cancer risk was increased, compared to 22% in people with cancer in the family. In addition, there were pronounced differences in the risk perception depending on the type of cancer. For example, 18% of people with colorectal and as many as 30% of people with gastric cancer in first-degree relatives assumed an increased risk of their own.
Furthermore, people with increased risk perception showed a significantly higher willingness to change certain lifestyle factors. For example, 64% of smokers with an increased risk perception were willing to give up smoking, compared to 46% of smokers who assessed their cancer risk as low. There were similar results for the motivation to increase physical activity (65 vs. 50%), eat more fruit and vegetables (77 vs. 56%) and consume less alcohol (44 vs. 26 %).
Ulrike Haug’s conclusion is compelling. “The potential to effectively implement cancer prevention measures in relatives of cancer patients should be used and further explored. Risk perception is the basis of effective and successful cancer prevention. It increases the willingness to actually change one’s own risk behavior. Both are much more common in people with close relatives suffering from cancer than in people who have been spared this fate. In view of the fact that from a medical point of view, the cancer risk is actually increased in relatives of cancer patients, prevention programs should be developed and adapted specifically for this risk group in addition to programs for the general population. Our study shows that they are absolutely open to it.”
The original article „First-degree relatives of cancer patients: A target group for primary prevention? A cross-sectional study” was published in the British Journal of Cancer (2018 Mar 21; doi: 10.1038/s41416-018-0057-2).
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