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Br J Cancer. 2017 Aug 8;117(4):461-469. doi: 10.1038/bjc.2017.189. Epub 2017 Jul 13.

Lifestyle predictors for non-participation and outcome in the second round of faecal immunochemical test in colorectal cancer screening.

Author information

Department of Bowel cancer screening, Cancer Registry of Norway, P.O. Box 5313, Majorstuen, Oslo 0304, Norway.
Department of Research and Development, Telemark Hospital, Ulefosseveien 55, Skien 3710, Norway.
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Blindern, P.O. Box 1046, Oslo 0317, Norway.
Department of Gastroenterology, Østfold Hospital Trust, Moss P.O. Box 1714, Sarpsborg 1714, Norway.
Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Blindern P.O. Box 1089, Oslo 0317, Norway.
Department of Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Sandvika, P.O. Box 800, Drammen 3004, Norway.
Institute of Clinical Medicine, University of Oslo, Blindern P.O. Box 1171, Oslo 0318, Norway.
Research and Development, Vestfold Hospital, Vestfold Hospital Trust, Tønsberg, P. O. 2168, Tønsberg 3103, Norway.
National Advisory Unit for Women's Health, Women's Clinic, Oslo University Hospital, Oslo 0424, Norway.



To reduce colorectal cancer (CRC) mortality through population-based screening programmes using faecal tests, it is important that individuals continue to participate in the repeated rounds of screening. We aimed to identify lifestyle predictors for discontinuation of faecal immunochemical test (FIT) screening after the first round, as well as lifestyle predictors for colorectal neoplasia detected in the second-round FIT screening.


In this longitudinal study, we invited 6959 individuals aged 50-74 years from south-east Norway for a first round of FIT screening and to complete a self-reported lifestyle questionnaire on demographic factors, body mass index (BMI, kg m-2), smoking habits, physical activity, consumption of alcohol and dietary items. Two years later, we estimated the associations between these factors, non-participation and screening results in the second round of FIT screening using adjusted odds ratios (ORs) and 95% confidence intervals (CIs).


Of the 3114 responders to the questionnaire who completed the first-round FIT and who were invited to participate in second-round FIT screening, 540 (17%) did not participate. The OR and (95% CI) for discontinuation of FIT screening after the first round was 1.61 (1.24-2.10) for current smoking compared with non-smoking; 2.01 (1.25-3.24) for BMI⩾35 kg m-2 compared with BMI 16.9-24.9 kg m-2 and 0.70 (0.52-0.94) for physical activity in the third quartile vs the first. Among participants, smoking, high BMI and high alcohol consumption were associated with an increased odds of detecting colorectal neoplasia (n=107).


These results may indicate that Norwegian FIT screening participants who discontinue after the first round have lifestyle behaviours associated with increased risk of CRC.

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