Epidemiologia dei Tumori II, AOU S Giovanni Battista - CPO Piemonte Torino, Italy.
Front Oncol. 2012 May 8;2:45. doi: 10.3389/fonc.2012.00045. eCollection 2012.
Unhealthy diet, physical inactivity, and smoking are key risk factors for the major non-communicable diseases such as cancer, cardiovascular diseases, and diabetes. The screening procedure may represent an ideal setting for promoting healthy lifestyles as it represents a time when subjects are probably more inclined to consider a relationship between their own habits and their effects on health. The aim of this study is to review available evidence concerning interventions combining screening and primary prevention interventions, aimed at promoting the adoption of healthy lifestyles.
We searched the MEDLINE and Cochrane library electronic databases for intervention studies of primary prevention interventions implemented in the context of established screening programmes, or of pilot screening projects, where the study design included a comparison group.
Comprehensive interventions are acceptable for asymptomatic subjects targeted for cancer screening, can result in improvements and may be cost-effective. A positive impact of these interventions in favoring the adoption of cancer protective dietary behaviors was observed in all studies. Conflicting results were instead reported with respect to physical activity, while no impact could be observed for interventions aimed to favor smoking cessation.
The retrieved studies suggest that the screening setting may offer valuable opportunities to provide credible, potentially persuasive life style advice, reaching a wide audience. A multiple risk factor approach may maximize the benefit of behavioral change, as the same health related habits are associated not only with cancers targeted by screening interventions, but also with other cancers, coronary artery disease, and other chronic conditions, while unhealthy behaviors may be mutually reinforcing. In order to cover a maximum number of possibilities, health education programmes should include multiple strategies, integrating and combining models of individual, social, and environmental change.
不健康的饮食、缺乏身体活动和吸烟是癌症、心血管疾病和糖尿病等主要非传染性疾病的关键风险因素。筛查程序可能代表促进健康生活方式的理想环境，因为它代表了一个受试者可能更倾向于考虑自己的习惯与健康之间关系的时刻。本研究的目的是回顾关于将筛查与初级预防干预相结合的干预措施的现有证据，旨在促进健康生活方式的采用。
我们在 MEDLINE 和 Cochrane 图书馆电子数据库中搜索了在既定筛查计划背景下或试点筛查项目中实施的初级预防干预措施的干预研究，其中研究设计包括对照组。
全面的干预措施对于针对癌症筛查的无症状受试者是可以接受的，可以改善情况，并且可能具有成本效益。所有研究都观察到这些干预措施对促进癌症保护饮食行为的采用具有积极影响。然而，对于身体活动，报告的结果则存在冲突，而对于旨在促进戒烟的干预措施，则没有观察到影响。
检索到的研究表明，筛查环境可能为提供可信、有潜力的生活方式建议提供有价值的机会，覆盖广泛的受众。多危险因素方法可以最大限度地提高行为改变的益处，因为相同的健康相关习惯不仅与筛查干预针对的癌症有关，而且与其他癌症、冠心病和其他慢性疾病有关，而不健康的行为可能相互加强。为了涵盖最大数量的可能性，健康教育计划应包括多种策略，整合和结合个人、社会和环境变化的模型。
