Adolescent Cancer Education (ACE) to increase adolescent and parent cancer awareness and communication: study protocol for a cluster randomised controlled trial Effect of physical activity and body size on survival after diagnosis with colorectal cancer
Background Raising cancer awareness among adolescents has potential to increase their knowledge and confidence in identifying cancer symptoms and seeking timely medical help in adolescence and adulthood . Detecting cancer at an early stage is important because it reduces the risk of dying of some cancers and thereby contributes to improved cancer survival . Adolescents may also play an important role in increasing cancer communication within families . However , there are no r and omised controlled trials ( RCT ) of the effectiveness of school-based educational interventions to increase adolescents ’ cancer awareness , and little is known about the role of adolescents in the upward diffusion of cancer knowledge to parents/carers . The aim of this study is to determine the effectiveness of a school-based educational intervention to raise adolescent and parent cancer awareness and adolescent-parent cancer communication . Methods The Adolescent Cancer Education ( ACE ) study is a school-based , cluster RCT . Twenty secondary schools in the area covered by Glasgow City Council will be recruited . Special schools for adolescents whose additional needs can not be met in mainstream education are excluded . Schools are r and omised to receive a presentation delivered by a Teenage Cancer Trust educator in Autumn 2013 ( intervention group ) or Spring 2014 following completion of six-month follow-up measures ( control group ) . Participants will be students recruited at the end of their first year of secondary education ( S1 ) ( age 12 to 13 years ) and one parent/carer for each student , of the student ’s choice . The primary outcome is recognition of cancer symptoms two weeks post-intervention . Secondary outcomes are parents ’ cancer awareness and adolescent-parent cancer communication . Outcomes will be assessed at baseline ( when adolescents are in the final term of S1 ) , two-week , and six-month follow-up ( when adolescents are in S2 , age 13 to 14 years ) . Differences in outcomes between trial arms will be tested using multiple regression methods , adjusted for clustering by school . An audit of cancer-related and health-promotion activity within the school curriculum and environment during the RCT will be conducted at six-month follow-up to context ualise the intervention effect . Discussion Results from the ACE study will provide evidence about the public health effectiveness of a school-based intervention design ed to increase adolescent and parent cancer awareness and adolescent-parent cancer communication . Trial registration IS RCT Background : Physical inactivity and obesity increase the risk of  colorectal cancer  but little is known about whether they influence prognosis after diagnosis . Methods : Incident cases of colorectal cancer were identified among participants of the Melbourne Collaborative Cohort Study , a prospect i ve cohort study of 41 528 Australians recruited from 1990 to 1994 . Participants diagnosed with their first colorectal cancer between recruitment and 1 August 2002 were eligible . At the time of study entry , body measurements were taken and participants were interviewed about their physical activity . Information on tumour site and stage , treatments given , recurrences , and deaths were obtained from systematic review of the medical records . Results : A total of 526 cases of colorectal cancer were identified . Median follow up among survivors was 5.5 years , and 208 deaths had occurred , including 181 from colorectal cancer . After adjusting for age , sex , and tumour stage , exercisers had an improved disease specific survival ( hazard ratio 0.73 ( 95 % confidence interval ( CI ) 0.54–1.00 ) ) . The benefit of exercise was largely confined to stage II – III tumours ( hazard ratio 0.49 ( 95 % CI 0.30–0.79 ) ) . Increasing per cent body fat result ed in an increase in disease specific deaths ( hazard ratio 1.33 per 10 kg ( 95 % CI 1.04–1.71 ) ) . Similarly , increasing waist circumference reduced disease specific survival ( hazard ratio 1.20 per 10 cm ( 95 % CI 1.05–1.37 ) ) . Conclusions : Increased central adiposity and a lack of regular physical activity prior to the diagnosis of colorectal cancer is associated with poorer overall and disease specific survival
Plain English summary This paper describes the methods that were used to develop a health behaviour intervention specifically for teenage and young adult cancer survivors ( TYACS ) .
Abstract Background Teenage and Young Adult Cancer Survivors ( TYACS ) are advised to adopt a healthy lifestyle in order to reduce the impact of cancer and its treatments upon their long-term health .
However , at present there are no interventions available in the UK to support TYACS to lead a healthy lifestyle .
Health care professionals were surveyed simultaneously to gather their views on how best to promote health behaviour change to TYACS .