Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, Japan.
Underwriting and Medical Department, The Dai-ichi Life Insurance Company, Limited, Koto-ku, Tokyo, Japan.
Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1063-1071. doi: 10.1158/1055-9965.EPI-20-1499. Epub 2021 Mar 26.
Risk prediction models offer a promising approach to lifestyle modification. We evaluated the effect of personalized advice based on cancer risk prediction in improving five lifestyle habits (smoking, alcohol consumption, salt intake, physical activity, and body mass index) compared with standard advice without risk prediction among a Japanese general population with at least one unhealthy lifestyle habit.
In a parallel-design, single-blind, randomized controlled trial between February 2018 and July 2019, 5984 participants aged 40-64 years with unhealthy lifestyle habits were recruited from persons covered under a life insurance policy. They were randomly assigned to an intervention or control group and received personalized or standard advice, respectively. They were also sent an invitation to participate in a lifestyle modification program aimed at improving lifestyle. Primary outcome was an improvement in lifestyle, defined as an increase in healthy lifestyle habits within 6 months.
The proportion of participants who improved their lifestyle within 6 months in the intervention group did not significantly differ from that in the control group (18.4% vs. 17.7%; = 0.488). Among participants with low health literacy and two or fewer of five healthy habits, the proportion of participants subscribing to the lifestyle modification program was higher in the intervention group than in the control group.
Compared with standardized advice, personalized advice based on cancer risk prediction had no effect on improving lifestyle.
Provision of predicted cancer risk information did not induce change in unhealthy lifestyle.
风险预测模型为生活方式改变提供了一种有前景的方法。我们评估了基于癌症风险预测的个性化建议对改善五种生活方式习惯（吸烟、饮酒、盐摄入量、身体活动和体重指数）的效果，与不进行风险预测的标准建议相比，在至少有一种不健康生活方式习惯的日本一般人群中。
在 2018 年 2 月至 2019 年 7 月期间，进行了一项平行设计、单盲、随机对照试验，共招募了 5984 名年龄在 40-64 岁之间、有不健康生活方式习惯的参保人。他们被随机分配到干预组或对照组，并分别接受个性化或标准建议。他们还收到了参加旨在改善生活方式的生活方式改变计划的邀请。主要结局是生活方式的改善，定义为在 6 个月内增加健康的生活方式习惯。
干预组在 6 个月内改善生活方式的参与者比例与对照组没有显著差异（18.4%比 17.7%；=0.488）。在健康素养低和五个健康习惯中只有两个或更少的参与者中，干预组参加生活方式改变计划的比例高于对照组。
与标准化建议相比，基于癌症风险预测的个性化建议对改善生活方式没有效果。
提供预测的癌症风险信息并没有导致不健康生活方式的改变。
