OBJECTIVES: Colorectal cancer (CRC) is the second most common cancer worldwide and has poorer prognosis when metastasised, tackling this is the main driver of prevention programs which have focused on early detection and removal of adenomatous polyps. As more is known about the influences dietary and lifestyle factors on development of CRC, efforts are moving towards primary prevention as a means of optimising cancer prevention. We set out to elicit how patients with adenoma consider trade-offs and weigh up their choices between different surveillance options; to examine the patient and healthcare-related characteristics that could influence these choices; to determine whether preferences of patients with adenoma vary by literacy or other non-health related factors; to examine the concordance of these preferences with studies of adherence to exercise programs for individuals with pre-cancerous detected lesions.

METHODS: Pilot online discrete choice experiment, n=231 participants (of 1200 invitees with known intermediate or high risk polyps removed during CRC screening test,) completed 8 sequential choice grids, containing information about 5 attributes related to risk reduction; diet & lifestyle program options combined with clinical testing information, estimated out-of-pocket costs for participation in primary prevention programs added to surveillance.

RESULTS: Predominantly male, married respondents, with 25.13% university educated, and self reported comorbidities, 27.6% with high blood pressure, 25.4% with high cholesterol, 10.1% with cardiac problems, demonstrate risk aversion preferences. 37.1% of participants were unaware of their own risk status following polypectomy, despite 41% receiving their results on the day of their procedure by their treating health professional. 38.3% were willing to make changes to diet and lifestyle, with 35.1% already making changes to reduce their risk of cancer.

CONCLUSIONS: Participants report preferences for risk minimisation and are willing to engage in diet and lifestyle programs which may optimise cancer prevention efforts following removal of adenomatous polyps in cancer screening programs.