Testing a breast cancer prevention and a multiple disease prevention weight loss programme amongst women within the UK NHS breast screening programme—a randomised feasibility study

Pilot and Feasibility Studies

Emma Barrett¹  David P. French²  Christopher J. Armitage³  Katharine Sellers⁴  Cheryl Lombardelli⁴  Helen Ruane⁴  Sarah McDiarmid⁴  Louise Donnelly⁴  Grace Cooper⁴  Mary Pegington⁵  Michelle Harvie⁶  Anthony Howell⁷  D. Gareth Evans⁸ 

[1] Department of Medical Statistics, Education and Research Centre, Manchester University NHS Foundation Trust, M23 9LT, Manchester, UK;Manchester Breast Centre, Oglesby Cancer Research Centre, The Christie, University of Manchester, 555 Wilmslow Rd., M20 4GJ, Manchester, UK;Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Coupland Street, M13 9PL, Manchester, UK;Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Coupland Street, M13 9PL, Manchester, UK;The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, M23 9LT, Manchester, UK;The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, M23 9LT, Manchester, UK;Division of Cancer Sciences, The University of Manchester, Wilmslow Road, M20 4BX, Manchester, UK;The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, M23 9LT, Manchester, UK;Manchester Breast Centre, Oglesby Cancer Research Centre, The Christie, University of Manchester, 555 Wilmslow Rd., M20 4GJ, Manchester, UK;The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, M23 9LT, Manchester, UK;Manchester Breast Centre, Oglesby Cancer Research Centre, The Christie, University of Manchester, 555 Wilmslow Rd., M20 4GJ, Manchester, UK;Division of Cancer Sciences, The University of Manchester, Wilmslow Road, M20 4BX, Manchester, UK;Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Rd., M20 4BX, Manchester, UK;The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, M23 9LT, Manchester, UK;Manchester Breast Centre, Oglesby Cancer Research Centre, The Christie, University of Manchester, 555 Wilmslow Rd., M20 4GJ, Manchester, UK;Genomic Medicine, Division of Evolution and Genomic Sciences, The University of Manchester, St Mary’s Hospital, Manchester University NHS Foundation Trust, Oxford Road, M13 9WL, Manchester, UK;

关键词: Breast screening;    Breast cancer;    Weight loss;    Behaviour change;    Cardiovascular risk;    NHS Health Check;    diabetes risk;    Website and phone programme;   

DOI  :  10.1186/s40814-021-00947-4

来源: Springer

【 摘 要 】

BackgroundExcess weight and unhealthy behaviours (e.g. sedentariness, high alcohol) are common amongst women including those attending breast screening. These factors increase the risk of breast cancer and other diseases. We tested the feasibility and acceptability of a weight loss/behaviour change programme framed to reduce breast cancer risk (breast cancer prevention programme, BCPP) compared to one framed to reduce risk of breast cancer, cardiovascular disease (CVD) and diabetes (T2D) (multiple disease prevention programme, MDPP).MethodsWomen aged 47-73 years with overweight or obesity (n = 1356) in the NHS Breast Screening Programme (NHSBSP) were randomised (1:2) to be invited to join a BCPP or a MDPP. The BCPP included personalised information on breast cancer risk and a web and phone weight loss/behaviour change intervention. The MDPP also included an NHS Health Check (lipids, blood pressure, HbA1c and personalised feedback for risk of CVD [QRISK2] and T2D [QDiabetes and HbA1c]). Primary outcomes were uptake and retention and other feasibility outcomes which include intervention fidelity and prevalence of high CVD and T2D risk. Secondary outcomes included change in weight.ResultsThe BCPP and MDPP had comparable rates of uptake: 45/508 (9%) vs. 81/848 (10%) and 12-month retention; 33/45 (73%) vs. 53/81 (65%). Both programmes had a high fidelity of delivery with receipt of mean (95% CI) 90 (88-98% of scheduled calls, 91 (86-95%) of scheduled e-mails and 89 (76-102) website entries per woman over the 12-month period. The MDPP identified 15% of women with a previously unknown 10-year CVD QRISK2 of ≥ 10% and 56% with 10-year Qdiabetes risk of ≥ 10%. Both groups experienced good comparable weight loss: BCPP 26/45 (58%) and MDPP 46/81 (57%) with greater than 5% weight loss at 12 months using baseline observation carried forward imputation.ConclusionsBoth programmes appeared feasible. The MDPP identified previously unknown CVD and T2D risk factors but does not appear to increase engagement with behaviour change beyond a standard BCPP amongst women attending breast screening. A future definitive effectiveness trial of BCPP is supported by acceptable uptake and retention, and good weight loss.Trial registrationISRCTN91372184, registered 28 September 2014.

【 授权许可】

CC BY