title: Lifestyle interventions are feasible in patients with colorectal cancer with potential short-term health benefits: a systematic review.
abstract: OBJECTIVE
  Lifestyle interventions have been proposed to improve cancer survivorship in patients with colorectal cancer (CRC), but with treatment pathways becoming increasingly multi-modal and prolonged, opportunities for interventions may be limited. This systematic review assessed the evidence for the feasibility of performing lifestyle interventions in CRC patients and evaluated any short- and long-term health benefits.
  
  
  METHODS
  Using PRISMA Guidelines, selected keywords identified randomised controlled studies (RCTs) of lifestyle interventions [smoking, alcohol, physical activity (PA) and diet/excess body weight] in CRC patients. These electronic databases were searched in June 2015: Dynamed, Cochrane Database, OVID MEDLINE, OVID EMBASE, and PEDro.
  
  
  RESULTS
  Fourteen RCTs were identified: PA RCTs (n = 10) consisted mainly of telephone-prompted walking or cycling interventions of varied durations, predominately in adjuvant setting; dietary/excess weight interventions RCTs (n = 4) focused on low-fat and/or high-fibre diets within a multi-modal lifestyle intervention. There were no reported RCTs in smoking or alcohol cessation/reduction. PA and/or dietary/excess weight interventions reported variable recruitment rates, but good adherence and retention/follow-up rates, leading to short-term improvements in dietary quality, physical, psychological and quality-of-life parameters. Only one study assessed long-term follow-up, finding significantly improved cancer-specific survival after dietary intervention.
  
  
  CONCLUSIONS
  This is the first systematic review on lifestyle interventions in patients with CRC finding these interventions to be feasible with improvements in short-term health. Future work should focus on defining the optimal type of intervention (type, duration, timing and intensity) that not only leads to improved short-term outcomes but also assesses long-term survival.
authors.affiliation: The University of Glasgow, Royal Alexandra Hospital, Corsebar Road, Paisley, PA2 9PN, UK. susanmoug@nhs.net.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Moug
authors.affiliation: The University of Glasgow, University Avenue, Glasgow, G12 8QQ, UK.
authors.forename: Adam
authors.initials: A
authors.lastname: Bryce
authors.affiliation: Physical Activity for Health Research Centre, Moray House School of Education, The University of Edinburgh, St. Leonard's Land, Holyrood Road, Edinburgh, EH8 8AQ, UK.
authors.forename: Nanette
authors.initials: N
authors.lastname: Mutrie
authors.affiliation: Centre for Public Health Nutrition Research, Division of Cancer Research, Ninewells Medical School, Level 7, Mailbox 7, Dundee, DD1 9SY, UK.
authors.forename: Annie S
authors.initials: AS
authors.lastname: Anderson
mesh_terms: D001835:Body Weight; D015179:Colorectal Neoplasms / Q000628:therapy*; D004032:Diet; D015444:Exercise; D005240:Feasibility Studies; D006262:Health; D006801:Humans; D008019:Life Style; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: Colorectal cancer; Lifestyle interventions; Patient outcomes