Cancer and Cancer Prevention

A Randomised Control Trial to Assess the Impact of a Lifestyle Intervention (ActWell) in Women Attending NHS Breast Screening Clinics (2017-2019)
(Funded by the Scottish Government, through the University of Dundee)

In Scotland, incidence of breast cancer is predicted to rise by 27% by 2030 and whilst there are measures to support reductions in morbidity and mortality, the breast cancer community is now turning to support weight management programmes in post-menopausal women. In Scotland, 72% of women aged 55 to 74 years have a BMI>25kg/m2. A recent feasibility study of a lifestyle intervention initiated in the NHS breast screening sites and delivered in the community reported significant findings in weight loss and increased activity after 12 weeks in intervention versus control groups.

The study aims to assess the benefits, costs and acceptability of a community delivered, weight management programme (ActWELL) in women attending routine breast cancer screening clinics.

ISM Staff: Martine Stead, Douglas Eadie and Jennifer McKell

Computer Says No: Harnessing the Gaming Community to Promote Health Messages for Cancer Prevention (2016 - 2018)
(Funded by Cancer Research UK)

Prevention tackles the burden of cancer mortality and morbidity. Encouraging positive behaviour changes could result in one-third of cancers being prevented through diet, weight and physical activity modifications. Computer games, a globally dominant form of electronic entertainment, offer an innovative way of delivering dietary messages and promoting health behaviour change. There is a need for research which engages the gaming community to look at how messages are built into existing designs, leveraging online games, rather than stand-alone games, whose larger existing communities might be harnessed.

The aim of this study is testing the hypothesis that online games and their supporting communities can be utilised to promote positive change in nutrition behaviours of online gamers. Following the person-based approach to develop an in-depth understanding of gamers’ and game developers’ perspectives and designing an intervention that is relevant, persuasive, accessible and engaging.

The team will carry out a literature review, focus groups and workshops.

ISM Staff: Richard Purves

External: Ian Redpath; Ethna McFerran, Queen’s University Belfast; Rebecca Beeken, University College London (all joint leads)

Living Well - A Feasibility Study to Assess the Impact of a Lifestyle Intervention in People Attending Family History Clinics with an Increased Risk of Colorectal or Breast Cancer (2015-2016)
(Funded by the Chief Scientist Office, Scottish Government)

For people who are at greater risk of cancer due to a family history of the disease (which may reflect shared genetic and behavioral profiles) it is important to follow recommendations for cancer screening and lifestyle. This study aimed to assess the feasibility and acceptability of delivering a 12-week lifestyle intervention programme (LivingWell) for people with a family history of BC and CRC initiated within the clinic setting in order to inform the design of a definitive randomised control trial (RCT) to assess the clinical and cost-effectiveness of this intervention. The primary outcome of the future RCT will be weight loss (with secondary outcomes of alcohol intake, physical activity, dietary intake, psycho-social parameters, weight monitoring procedures and cost effectiveness). This was done through a two arm, two-centre, randomised feasibility study of the LivingWELL intervention versus usual care.

ISM Staff: Martine Stead

(Funded by Chief Scientist Office)

Colorectal cancer (CRC) survival has improved, but in Scotland, survivors still have notable excess mortality within the first year post diagnosis compared to other European countries. In addition, survivors have high rates of co-morbidities. This study aims to assess the feasibility of delivering an intervention programme (TreatWELL) for CRC patients undergoing potentially curative treatments. The programme will facilitate stepped changes towards smoking cessation, increase in activity to 150 minutes and caloric intake appropriate to weight status. Feasibility outcomes include recruitment rates, ease of programme implementation, adherence, patient acceptability of the programme factors influencing adherence, retention and delivery costs.

ISM Staff: Martine Stead, Douglas Eadie and Jennifer McKell

Reducing Lifestyle Associated Cancer Risk in People Attending Family History Clinics
(Funded by Dundee Cancer Centre)

This collaborative, multi-disciplinary, project aims to assess modifiable health behaviours associated with increased risk of breast/colorectal cancer and to identify promising approaches to the design and uptake of interventions amongst attendees of family history clinics. It is aimed at  informing a full research proposal to assess the impact of an innovative intervention trial on reducing lifestyle associated cancer risk in people referred to NHS family history clinics.

ISM Staff: Martine Stead and Douglas Eadie

Cancer Diagnosis as an Opportunity for Increasing Uptake of Smoking Cessation Services among Families: An Exploratory Study of Patients’, Family members’ and Health Professionals’ Views
(Funded by the Chief Scientist Office)

Smoking after a diagnosis of cancer is associated with significantly worse morbidity and mortality, therefore uptake of effective smoking cessation services is particularly important for people with cancer. Evidence suggests that cancer diagnosis can be a powerful catalyst to behaviour change. However, the influence of family members and health professionals at this highly emotive time is likely to be important, and there is considerable evidence to suggest that opportunities to discuss smoking cessation with patients and families are currently under-used. This qualitative study explores the experiences and views of patients, family members and healthcare professionals in relation to smoking and smoking cessation around the time of a cancer diagnosis, in order to identify whether and how recently diagnosed cancer patients and their close family members can effectively and appropriately be encouraged to engage with smoking cessation services. Findings will be used to identify a number of potential approaches to improve uptake of existing smoking cessation services in the context of a cancer diagnosis, and consensus will be established through a nominal group technique, using an expert group comprised of health care professionals and patient advisors. For further information contact Mary Wells.

ISM Staff: Linda Bauld

Research Team: Mary Wells, Brian Williams, Gozde Ozakinci, Alastair Munro, Vikki Entwistle, Sally Haw, Andrew Radley, Fiona Harris

BeWEL - Development and Evaluation of a Lifestyle Intervention
(Commissioned by the Medical Research Council)

The BeWEL study, led by Professor Annie Anderson at the University of Dundee, aims to develop and evaluate the impact of a lifestyle (diet, physical activity and behaviour change) intervention programme ("BeWEL”) on body weight change and waist circumference in healthy individuals attending routine NHS clinics who have had pre-cancerous bowel polyps removed. A 3 year, two-arm, multicentre, randomised controlled trial is being conducted to compare the BeWEL programme against usual care for men and women aged 50 to 74. The study's primary outcome measures are changes in body weight and waist circumference. Secondary outcomes will include cardiovascular risk factors, psycho-social measures and intervention costs.

ISM is one of the collaborating partners in the study. Our role is twofold: to conduct qualitative exploratory research with individuals representative of the target group, to help inform the development of the intervention, and to conduct a process evaluation to explore feasibility and acceptability of the interventions' implementation.

Other partners in BeWEL are: University of Dundee, University of Aberdeen, University of Strathclyde, and University College London.

ISM Staff: Martine Stead and Jennifer McKell

Anderson AS, Caswell S, Macleod M, Craigie AM, Stead M, Steele RJC and the BeWEL Team (2015). Awareness of lifestyle and colorectal cancer risk: Findings from the BeWEL study. BioMed Research International, 2015.

Stead M, Craigie AM, Macleod M, McKell J, Caswell S, Steele RJ and Anderson AS (2015). Why are some people more successful at lifestyle change than others? Factors associated with successful weight loss in the BeWEL randomised controlled trial of adults at risk of colorectal cancer. International Journal of Behavioral Nutrition and Physical Activity, 12: 87. doi:10.1186/s12966-015-0240-2

Anderson A, Craigie AM, Caswell S, Treweek S, Stead M, Macleod M, Daly F, Belch J, Rodger J, Kirk A, Ludbrook A, Rauchhaus P, Norwood P, Thompson J, Wardle J and Steele RJ (2014). The impact of a bodyweight and physical activity intervention (BeWEL) initiated through a national colorectal cancer screening programme: randomised controlled trial. British Medical Journal, 348: g1823. doi: 10.1136/bmj.g1823.

Treweek  S, Wilkie  E, Craigie AM, Caswell  S, Thompson  J, Steele RJC, Stead  M and Anderson AS (2013 Online). Meeting the challenges of recruitment to multicentre, community-based, lifestyle-change trials: A case study of the BeWEL trial. Trials, 14: 436. doi: 10.1186/1745-6215-14-436.

Caswell S, Craigie AM, Wardle J, Stead M, Anderson AS and the BeWEL team (2012). Detailed protocol for the lifestyle intervention in the BeWEL randomised controlled trial of weight loss in adults who have had a colorectal adenoma. BMJ OPEN, 2(3): e001276, doi:10.1136/bmjopen-2012-001276.

Stead M, Casswell S, Craigie AM, Eadie D and Anderson AS (2012). Understanding the potential and challenges of adenoma treatment as a prevention opportunity: Insights from the BeWEL formative study. Preventive Medicine, 54: 97-103. Online

Craigie AM, Caswell S, Paterson C, Treweek S, Belch JJ, Daly F, Rodger J, Thompson J, Kirk A, Ludbrook A, Stead M, Wardle J, Steele RJ, Anderson AS (2011).  Study protocol for BeWEL: The impact of a BodyWEight and physicaL activity intervention on adults at risk of developing colorectal adenomas.  BMC Public Health, 11: 184.  Online

University News

Improving Breast Awareness in Women Aged 45-54 Years
(Commissioned by Breakthrough Breast Cancer)

One in every nine women in the UK will develop breast cancer at some point during their lives. Accounting for nearly one-third of all cancers in women, breast cancer is the leading cause of death for women aged 34 to 54 (ONS 2005). Improving breast awareness and increasing the uptake of breast screening amongst women is a key factor in the fight against breast cancer.

The Breakthrough Breast Cancer project supported the development, implementation and evaluation of a pilot breast cancer education and awareness campaign. The campaign had two main aims: to improve knowledge and awareness of breast cancer (including the benefits of early diagnosis), breast awareness and breast screening; and to promote early detection. ISM conducted an integrated research programme which included a review of the published literature evaluating breast cancer awareness and an in-depth exploration of women's current knowledge, perceptions and attitudes towards breast cancer using qualitative research methodology. The findings of this research were used to guide the development of Breakthrough Breast Cancer's education and awareness campaign.

ISM Staff: Joanne Freeman (left 2008) and Douglas Eadie

Ovarian Cancer Leaflet Evaluation
(Commissioned by Cancer Research UK)

Cancer Research UK developed a new series of lifestyle and cancer awareness leaflets to complement the existing series of cancer-specific leaflets. At the time it had 11 cancer awareness leaflets, mostly dealing with specific cancers. In 2007 it added a new title to the series - ovarian cancer. It was intended that the leaflet would provide advice on early detection and how to reduce the risk of ovarian cancer. ISM undertook a series of focus group discussions with women in Scotland and England to help with the development of the leaflet by identifying appropriate ways to communicate CRUK's key messages about the early detection and risk of ovarian cancer, and examine the accessibility and tone of the leaflet text, the attractiveness of the design, and the 'pickup' ability of the leaflet as a whole.

ISM Staff: Laura McDermott (left 2008) and Douglas Eadie