Objective: Approximately 800,000 people die globally from colorectal cancer (CRC) every year. Prevention programmes promote early detection, but for people with pre-cancerous lesions, tailoring surveillance to include lifestyle-change programmes could enhance prevention potential and improve outcomes.
Methods:Those with intermediate or high-risk polyps removed during CRC-screening colonoscopy within the Northern Ireland CRC Screening programme were invited to complete 8 discrete choice questions about tailored surveillance, analysed using random-parameters logit and latent class modelling approach.Results: 231 participants, (77% male) self-reported comorbid hypertension (53%), high cholesterol (48%) and mean BMI of 28.7 (overweight). Although 39% of participants were unaware of their CRC risk-status, 30.9% indicated they were already making changes to reduce their risk. Although all respondents were significantly risk and cost averse, the latent class analysis identified three segments (classes): i)Class 1 (26.8%) significantly favoured phone or email support for a lifestyle change, a 17-month testing interval, and non-invasive testing.ii) Class 2 (48.4%) preferred the status-quo.iii) Class 3 (24.7%) significantly favoured further risk reduction and invasive testing.Conclusions: This is the first documented preference study focusing on post-polypectomy surveillance offering lifestyle interventions. Although current care is strongly preferred, risk and cost aversion are important for participants. Latent class analysis shows that some respondents are willing to change diet and lifestyle behaviours, reflecting a teachable moment, with opportunities to personalise and optimise surveillance. Significant discordance between perceived and known risk of recurrence and limited recall of risk information provided within current practice suggest necessary improvements to surveillance programmes.