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Project PREVENT: A Randomized Trial to Reduce Multiple Behavioral Risk Factors for Colon Cancer

¹ Dana-Farber Cancer Institute and Harvard School of Public Health; ² Harvard Medical School and Harvard Vanguard Medical Associates, Boston, Massachusetts; ³ Duke Comprehensive Cancer Center; ⁴ Duke University School of Nursing and Geriatric Research Education and Clinical Center, Durham VA Medical Center, Durham, North Carolina; ⁵ University of Massachusetts, Amherst, Massachusetts; and ⁶ Brown University Medical School and the Miriam Hospital, Providence, Rhode Island

Requests for reprints: Karen M. Emmons, The Dana-Farber Cancer Institute, Center for Community-Based Research, 44 Binney Street, Boston, MA 02115. Phone: 617-632-2188; Fax: 617-632-5690. E-mail: karen_m_emmons{at}dfci.harvard.edu

Background: This report examines the outcome data for Project PREVENT, a two-site randomized control trial designed to reduce behavioral risk factors for colorectal cancer among individuals who have been diagnosed with adenomatous colon polyps.

Methods: The study sample included 1,247 patients with recent diagnosis of adenomatous colorectal polyps. Within 4 weeks following the polypectomy, participants completed a baseline survey by telephone, and were randomized to either Usual Care (UC) or the PREVENT intervention, which was designed to target multiple risk factors. The intervention consisted of a telephone-delivered intervention plus tailored materials, and focused on the six primary behavioral risk factors for colorectal cancer, including red meat consumption, fruit and vegetable intake, multivitamin intake, alcohol, smoking, and physical inactivity.

Results: Participation in the PREVENT intervention was associated with a significantly greater reduction in prevalence of multiple risk factors for colorectal cancer compared with UC. Only about one third of UC participants dropped any risk factors during the study period, compared with almost half of the PREVENT participants. PREVENT participants were also significantly more likely to change more than one behavior than UC participants.

Conclusions: The PREVENT intervention was effective in helping patients change multiple risk factors. These results provide further support that more comprehensive interventions that move beyond emphasis on a single risk factor are acceptable to patient populations, can result in improvements, and are cost effective.

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