PROCAS Lifestyle

Diet - Prevent Breast Cancer

Prevent Breast Cancer researchers have estimated risk of breast cancer for 55,000 women in the breast screening programme in the PROCAS study. Around one percent of women are at high risk (30% or greater lifetime risk), nine percent are at moderately increased risk (between 20 and 30% lifetime risk) seventy percent are at average risk (between 4 and 20% lifetime risk) and 20% below average risk (lifetime risk  less than 4%). PROCAS lifestyle is a follow up study to testing the following research questions:

  • Can we can engage overweight women from all of these risk categories to a diet and exercise weight loss programme?
  • Does level of breast cancer risk influence uptake and adherence to the programme?
  • Do women in the breast screening programme have increased risks and/ or concerns about their risk of other cancers, diabetes, heart disease, stroke and dementia?
  • Can we support weight loss with our novel web based 2 day diet and exercise weight loss programme?

Background

Rising trends in trends of obesity, sedentary lifestyle, unhealthy diet and high alcohol intakes are increasing rates of breast cancer and other lifestyle related diseases in the UK.

Currently 65% of women in the UK are overweight and 25% obese.  Losing five percent of your weight or more and keeping it off can reduce your risk of developing breast cancer by 25 – 40%.This weight loss will halve your risk of diabetes and reduce your chance of stroke and heart disease by 30% .

The problems of obesity and unhealthy lifestyle and the cost to the NHS has had much media coverage, and has been highlighted as a priority by the government. However, the NHS has few effective services to tackle these trends in obesity and unhealthy lifestyle, and there is a need for new approaches.

We are testing whether we can target women in the NHS Breast Screening Programme (NHSBSP) with lifestyle prevention of breast cancer and other diseases. Changing people’s behaviour can be difficult to achieve and costly for the NHS.

We have shown that telephone support seems useful and potentially very cost effective. We now wish to see whether a web based programme which gives feedback to women can support women to achieve weight loss and behaviour change.

Current Situation

Our recent expert report Howell et al (BREAST CANCER CAMPAIGN GAP ANALYSIS (Howell A, Anderson AS, Clarke RB, Duffy SW, Evans D, Garcia-Closas M, Gescher AJ, Key TJ, Saxton JM, Harvie MN. Risk determination and prevention of breast cancer. Breast Cancer Res. 2014 Sep 28;16(5):446.) widely covered in the media estimated that we could prevent 30% of breast cancer cases through lifestyle changes:

 Weight control

  • Increasing activity
  • Reduced alcohol intake

The NHSBSP service reaches approximately 70% of women in the UK aged 47 to 73 years. The NHSBSP allows early diagnosis and improved breast cancer survival but does not currently tackle breast cancer prevention.

What happens on the study?

We are conducting a study that assesses if we can introduce lifestyle change for breast cancer prevention, as well as introduce risk screening for other diseases such as heart disease, stroke and diabetes amongst women in the NHS breast screening programme.

This study, led by Dr Harvie, will involve 120 overweight women from the breast screening programme who will receive their personal disease risk for breast cancer, heart disease, stroke and diabetes and dementia, three months of personalised phone, mail and web supported PROCAS lifestyle programme followed by three months of web support.

The Future

The data from this study is essential to support a future large scale clinical trial which will test the effectiveness, health care costs, and potential reduction in risk of breast cancer and other diseases of this tailored lifestyle programme. This proposal has the support of Diabetes UK and the British Heart Foundation. We believe this project is one step closer to preventing breast cancer.