{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T07:17:47Z","timestamp":1781507867735,"version":"3.54.1"},"reference-count":32,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Gut"],"accepted":{"date-parts":[[2014,8,15]]},"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>There is uncertainty whether cancer screening affects participant incentives for favourable lifestyle. The present study investigates long-term effects of colorectal cancer (CRC) screening on lifestyle changes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>In 1999\u20132001, men and women drawn from the population registry were randomised to screening for CRC by flexible sigmoidoscopy (\u2018invited-to-screening\u2019 arm) or to no-screening (control arm) in the Norwegian Colorectal Cancer Prevention trial. A subgroup of 3043 individuals in the \u2018invited-to-screening\u2019 and 2819 in the control arm, aged 50\u201355\u2005years, randomised during 2001 had their lifestyle assessed by a questionnaire at inclusion and after 11\u2005years (42% of cohort). The outcome was 11-year changes in lifestyle factors (body weight, smoking status, physical exercise, selected dietary habits) and in total lifestyle score (0\u20134 points, translating to the number of lifestyle recommendations adhered to). We compared outcomes in the two randomisation arms and attendees with positive versus negative findings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Total lifestyle scores improved in both arms. The improvement was smaller in the \u2018invited-to-screening\u2019 arm (score 1.43 at inclusion; 1.58 after 11\u2005years) compared with the control arm (score 1.49 at inclusion; 1.67 after 11\u2005years); adjusted difference \u22120.05 (95% CI \u22120.09 to \u22120.01; p=0.03). The change in the score was less favourable in screening attendees with a positive compared with negative screening result; adjusted difference \u22120.16 (95% CI \u22120.25 to \u22120.08; p&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The present study suggests that possible unfavourable lifestyle changes after CRC screening are modest. Lifestyle counselling may be considered as part of cancer screening programmes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>NCT00119912.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/gutjnl-2014-307376","type":"journal-article","created":{"date-parts":[[2014,9,3]],"date-time":"2014-09-03T09:20:58Z","timestamp":1409736058000},"page":"1268-1276","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Long-term lifestyle changes after colorectal cancer screening: randomised controlled trial"],"prefix":"10.1136","volume":"64","clinical-trial-number":[{"clinical-trial-number":"nct00119912","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Paula","family":"Berstad","sequence":"first","affiliation":[{"name":"Department of Research and Development, Telemark Hospital, Skien, Norway"},{"name":"Cancer Registry of Norway, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"L\u00f8berg","sequence":"additional","affiliation":[{"name":"Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway"},{"name":"Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA"},{"name":"Department of Gastroenterology, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger Kristin","family":"Larsen","sequence":"additional","affiliation":[{"name":"Cancer Registry of Norway, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"Kalager","sequence":"additional","affiliation":[{"name":"Department of Research and Development, Telemark Hospital, Skien, Norway"},{"name":"Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway"},{"name":"Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d8yvind","family":"Holme","sequence":"additional","affiliation":[{"name":"Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway"},{"name":"Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA"},{"name":"Department of Medicine, S\u00f8rlandet Hospital, Kristiansand, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Botteri","sequence":"additional","affiliation":[{"name":"Cancer Registry of Norway, Oslo, Norway"},{"name":"Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Bretthauer","sequence":"additional","affiliation":[{"name":"Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway"},{"name":"Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA"},{"name":"Department of Gastroenterology, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geir","family":"Hoff","sequence":"additional","affiliation":[{"name":"Department of Research and Development, Telemark Hospital, Skien, Norway"},{"name":"Cancer Registry of Norway, Oslo, Norway"},{"name":"Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,9,2]]},"reference":[{"key":"2025090723551110000_64.8.1268.1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001352"},{"key":"2025090723551110000_64.8.1268.2","first-page":"CD009259","article-title":"Flexible sigmoidoscopy versus faecal occult blood testing for colorectal cancer screening in asymptomatic individuals","volume":"9","author":"Holme","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"2025090723551110000_64.8.1268.3","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdq050"},{"key":"2025090723551110000_64.8.1268.4","doi-asserted-by":"crossref","first-page":"45","DOI":"10.3389\/fonc.2012.00045","article-title":"Population based cancer screening programme as a teachable moment for primary prevention interventions. 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