Breast screening could act as 'trigger' for lifesaving lifestyle changes

Using breast screening clinics to introduce lifestyle advice has the potential to improve women's health, a study from the universities of Aberdeen and Dundee has found.

Researchers found that a programme that supported women to make dietary changes and increase physical activity doubled the likelihood of clinically significant weight loss after just 12 months.

The ActWELL initiative, funded by the Scottish Government, was introduced to women attending regular NHS breast screening appointments. After 12 months, those who opted to participate in the programme reduced their weight, a contributory cause of cancer, by an average of 2.5kg.

With obesity a known factor for breast cancer, experts believe that expanding such an initiative could have an important influence on rates of cancer and other obesity related diseases for women.

"Our study has shown that structured guidance on physical activity and diet using important techniques from health psychology could have a major effect on breast cancer risk," said Professor Annie Anderson, from Dundee's School of Medicine.

"We all know that diet and exercise contribute greatly to our overall health, but sometimes the direct links between these factors and cancer can be forgotten. Promoting heathier lifestyle options at a time when women are attending breast screening appointments could be the reminder that triggers many into adopting habits that could potentially save lives."

Breast cancer is the most common cancer in women worldwide, while in Scotland, the disease accounts for 29% of all cancers diagnosed. It is estimated that around 30% of breast cancers in post-menopausal women are related to lifestyle, while a sustained weight loss of between 2-4.5kg is associated with an 18% lower risk of breast cancer.

Professor Anderson, working with colleagues from four other Scottish universities, used a randomised trial involving 560 women aged between 50 and 70 who attended four NHS Breast Screening Centres across Scotland. Those who volunteered for the ActWELL programme were divided into two groups, with 278 taking part in the lifestyle programme and a further 281 in a comparison group who received the standard care afforded to women attending routine breast screening.

The ActWELL programme was delivered by volunteer lifestyle coaches recruited and managed by the research and care charity Breast Cancer Now. During the trial, the volunteers delivered 523 face-to-face sessions and had 1915 telephone support calls with participants. Initial sessions gave volunteers the chance to discuss a participant's diet and physical activity, while identifying weight loss goals. Follow up phone calls allowed the two parties to discuss progress and provided an opportunity for the volunteers to provide encouragement and direction.

Nearly all participants (99.7%) said being offered an opportunity to participate in a lifestyle programme when attending breast screening appointments would make no difference or increase (35%) likelihood of re-attending.

Professor Shaun Treweek, from the University of Aberdeen, added: "ActWELL has shown that volunteer coaches, working with a charity, really can help reduce women's breast cancer risk. The support offered by volunteers was key to ActWELL's success."

Health Secretary Jeane Freeman said, "We are grateful for the work which has gone into this study and welcome its findings which are an important step forward in our understanding of delivering health interventions to drive behaviour change.

"The outcomes of the study are now being considered as part of our ongoing work to further reduce inequalities and support cancer prevention work."

Baroness Delyth Morgan, Chief Executive at Breast Cancer Now, said, "We are proud to have supported the ActWELL trial by recruiting and training volunteers and give our huge thanks to all the volunteers for their support.

"Around 55,000 women each year in the UK get the terrible news that they have breast cancer, and while many factors affect how likely someone is to be diagnosed, we urgently need to find new ways to prevent people from developing this devastating disease.

"Maintaining a healthy weight is one way that women can lower their risk of developing breast cancer. The results of this trial show the benefits of giving women access to weight-loss support at their routine breast screening appointment, helping them to make lifestyle changes that can in turn help reduce their risk of developing the disease. More research is now needed to find ways to help women maintain a healthier weight, but we hope this trial will lead to less women being diagnosed with breast cancer in the future."