Usher-Smith Juliet A, Silarova Barbora, Sharp Stephen J, Mills Katie, Griffin Simon J
The Primary Care Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK.
BMJ Open. 2018 Jan 23;8(1):e017717. doi: 10.1136/bmjopen-2017-017717.
To provide a comprehensive review of the impact on intention to change health-related behaviours and health-related behaviours themselves, including screening uptake, of interventions incorporating information about cancer risk targeted at the general adult population.
A systematic review and random-effects meta-analysis.
An electronic search of MEDLINE, EMBASE, CINAHL and PsycINFO from 1 January 2000 to 1 July 2017.
Randomised controlled trials of interventions including provision of a personal estimate of future cancer risk based on two or more non-genetic variables to adults recruited from the general population that include at least one behavioural outcome.
We included 19 studies reporting 12 outcomes. There was significant heterogeneity in interventions and outcomes between studies. There is evidence that interventions incorporating personalised cancer risk information do not affect intention to attend or attendance at screening (relative risk 1.00 (0.97-1.03)). There is limited evidence that they increase smoking abstinence, sun protection, adult skin self-examination and breast examination, and decrease intention to tan. However, they do not increase smoking cessation, parental child skin examination or intention to protect skin. No studies assessed changes in diet, alcohol consumption or physical activity.
Interventions incorporating personalised cancer risk information do not affect uptake of screening, but there is limited evidence of effect on some health-related behaviours. Further research, ideally including objective measures of behaviour, is needed before cancer risk information is incorporated into routine practice for health promotion in the general population.
全面综述针对一般成年人群体、纳入癌症风险信息的干预措施对改变健康相关行为的意愿以及健康相关行为本身（包括筛查接受情况）的影响。
系统综述和随机效应荟萃分析。
对2000年1月1日至2017年7月1日期间的MEDLINE、EMBASE、CINAHL和PsycINFO进行电子检索。
干预措施的随机对照试验，包括根据两个或更多非基因变量为从一般人群中招募的成年人提供未来癌症风险的个人估计，且该试验包括至少一项行为结果。
我们纳入了19项报告12项结果的研究。各研究之间在干预措施和结果方面存在显著异质性。有证据表明，纳入个性化癌症风险信息的干预措施不会影响参加筛查的意愿或实际筛查情况（相对风险1.00（0.97 - 1.03））。仅有有限证据表明这些措施能增加戒烟、防晒、成人皮肤自我检查和乳房检查，并降低晒黑意愿。然而，它们不会增加戒烟、父母对儿童皮肤检查或保护皮肤的意愿。没有研究评估饮食、饮酒或身体活动方面的变化。
纳入个性化癌症风险信息的干预措施不会影响筛查的接受情况，但对某些健康相关行为的影响证据有限。在将癌症风险信息纳入一般人群健康促进的常规实践之前，需要进一步研究，理想情况下包括对行为的客观测量。
