School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
Health Promot Chronic Dis Prev Can. 2022 Feb;42(2):79-93. doi: 10.24095/hpcdp.42.2.04.
Adherence to cancer prevention recommendations can greatly reduce colorectal cancer risk. This study explored patterns and determinants of adherence to these recommendations by participants (n = 26 074) at baseline in a cohort study in British Columbia, Canada.
Adherence to five colorectal cancer primary prevention behaviours derived from Canadian Cancer Society/World Cancer Research Fund recommendations (nonsmoking, body mass index (BMI), physical activity, alcohol consumption and fruit and vegetable consumption) was measured, and a composite score constructed based on their sum. The definition of secondary prevention adherence was based on the Canadian Task Force on Preventive Health Care recommendations for colorectal cancer screening.
Adherence to primary prevention guidelines ranged from 94.8% (nonsmoking) to 44.2% (healthy BMI). Median composite score was 4. Higher composite scores were associated with being female, being married and with a higher educational attainment. Colorectal cancer screening adherence was 62.4%. Older age, chronic conditions, a recent medical examination and higher income were associated with greater odds of adherence to screening.
Adherence to some colorectal cancer prevention behaviours was high, consistent with findings that British Columbia has low rates of many risky health behaviours. However, there was a clustering of poorer adherence to prevention behaviours with each other and with other risk factors. Screening adherence was high but varied with some sociodemographic and health factors. Future work should evaluate targeted interventions to improve adherence among those in the lowest socioeconomic status and health groups. A better understanding is also needed of the barriers to access and engagement with colorectal cancer screening that persist even in the Canadian public health care system.
遵循癌症预防建议可以大大降低结直肠癌的风险。本研究通过对加拿大不列颠哥伦比亚省队列研究中的参与者（n=26074）在基线时的调查，探讨了他们对这些建议的依从模式和决定因素。
根据加拿大癌症协会/世界癌症研究基金会的建议，对 5 种结直肠癌初级预防行为（不吸烟、体重指数（BMI）、身体活动、饮酒和水果与蔬菜摄入）的依从性进行了测量，并根据它们的总和构建了一个综合评分。二级预防依从性的定义基于加拿大预防保健工作组对结直肠癌筛查的建议。
初级预防指南的依从率从 94.8%（不吸烟）到 44.2%（健康 BMI）不等。中位数综合评分为 4 分。更高的综合评分与女性、已婚和更高的教育程度有关。结直肠癌筛查的依从率为 62.4%。年龄较大、慢性疾病、最近的体检和较高的收入与更高的筛查依从率相关。
一些结直肠癌预防行为的依从率较高，这与不列颠哥伦比亚省许多危险健康行为发生率较低的发现一致。然而，与其他风险因素一起，预防行为的依从性较差存在聚集现象。筛查的依从率较高，但存在一些社会人口学和健康因素的差异。未来的工作应该评估有针对性的干预措施，以提高处于最低社会经济地位和健康群体的依从率。还需要更好地了解在加拿大公共医疗保健系统中仍然存在的与获得和参与结直肠癌筛查相关的障碍。
