Promoting changes in diet and physical activity in breast and colorectal cancer screening settings: an unexplored opportunity for endorsing healthy behaviors

The importance of diet, physical activity, and weight management in breast and colorectal cancer prevention is widely recognized. While there may be many “teachable moments” that could be used to assess and initiate changes in these behaviors by health professionals (to complement public health campaigns), there is little evidence that lifestyle is discussed within cancer screening settings. The lack of advocacy about lifestyle in these settings may endorse poor health behaviors, in particular the absence of guidance to visibly obese patients. To fully use the teachable moment, patients need to be aware of the relationship between diet and physical activity and the risk of cancer and to be able to relate guidance to personal behaviors. Results from cardiovascular and diabetes prevention programs provide evidence about the components of effective behavior change programs which could be used in the screening setting. Findings from interventions initiated in the colorectal cancer screening setting suggest that such programs can be delivered but it is not clear how acceptable these are in routine health services. Effective interventions delivered in this setting also offer an important opportunity to contribute to the reduction of the overall burden of chronic non-communicable diseases