Obesity is a known risk factor for breast cancer. The ActWELL trial, funded by the Scottish Government aimed to help women reduce their future risk of breast cancer by supporting them to reduce their weight and increase physical activity. Although ActWELL was mainly a community-based trial, ActWELL was initially introduced to women attending regular NHS breast screening appointments. After 12 months, those who took part in the programme reduced their weight, a contributory cause of cancer, by an average of 2.5kg.
Breast cancer is the most common cancer in women worldwide, while in Scotland, the disease accounts for 29% of all cancers diagnosed. It is estimated that around 30% of breast cancers in post-menopausal women are related to lifestyle, while a sustained weight loss of between 2-4.5kg is associated with an 18% lower risk of breast cancer.
Professor Annie Anderson, University of Dundee, working with colleagues from four other Scottish universities including Professor Shaun Treweek from the Health Services Research Unit, University of Aberdeen, used a randomised trial involving 560 women aged between 50 and 70 who attended four NHS Breast Screening Centres across Scotland. Those who volunteered for the ActWELL programme were divided into two groups, with 278 taking part in the lifestyle programme and a further 281 in a comparison group who received standard care (which means no offer of support).
The ActWELL programme was delivered by volunteer lifestyle coaches recruited and managed by the research and care charity Breast Cancer Now. During the trial, the volunteers delivered 523 face-to-face sessions and had 1915 telephone support calls with participants. Initial sessions gave volunteers the chance to discuss a participant’s diet and physical activity, while identifying weight loss goals. Follow up phone calls allowed the two parties to discuss progress and provided an opportunity for the volunteers to provide encouragement and direction.
Nearly all participants (99.7%) said being offered an opportunity to participate in a lifestyle programme when attending breast screening appointments would make no difference or increase likelihood of re-attending. In other words, breast screening appointments do provide an opportunity for prevention initiatives without affecting womens’ thoughts about reattendance at screening itself.
Discussions with Scottish Government and others are ongoing regarding next steps for ActWELL.
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