Bowel Cancer Screening May Have Small Unwanted Lifestyle Effect

Paula Berstad, PhD, postdoc Telemark Hospital c/o Cancer Registry of Norway Oslo, Interview Invitation
Paula Berstad, PhD, postdoc

Telemark Hospital
c/o Cancer Registry of Norway
Oslo, Norway


Medical Research: What are the main findings of the study?

Dr. Berstad: In general population of age 50-55 years, both those invited to bowel cancer screening in year 2001 by flexible sigmoidoscopy and those not invited improved their lifestyle from year 2001 to 2012. Lifestyle was measured as adherence to public health guidelines; non-smoking, daily physical exercise, healthy diet and normal body weight. However, the 11-year improvement was smaller in those who were screened for bowel cancer compared to those not screened. Further, among those who attended the screening, the improvement was smaller in those with findings at screening (positive screening result) compared to those without findings (negative screening result). Our interpretation of the findings is that bowel cancer screening may have a small unwanted effect on lifestyle. Particularly, attention should be given to lifestyle among those testing positive at screening.

Medical Research: Were any of the findings unexpected?

Dr. Berstad: It was surprising that the differences in lifestyle change between the screened and non-screened, first were observed three years after screening, still were observable eight years later.

Medical Research: What should clinicians and patients take away from your report?

Dr. Berstad: Cancer screening may have a small “health certificate” effect which reduces individual’s own incentives for healthy lifestyle choices. Although this effect is modest and without clinical importance, it may have impact on long-term health on the population level. Combining cancer screening with lifestyle counselling might be considered.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Berstad: Future research should pursue to find an optimal way to do cancer screening, which motivates the participant for favorable health behaviour.


Long-term lifestyle changes after colorectal cancer screening: randomised controlled trial

Paula Berstad, Magnus Løberg, Inger Kristin Larsen, Mette Kalager, Øyvind Holme, Edoardo Botteri, Michael Bretthauer, Geir Hoff

Gut gutjnl-2014-307376Published Online First: 2 September 2014 doi:10.1136/gutjnl-2014-307376


Last Updated on September 5, 2014 by Marie Benz MD FAAD