Background: Colorectal cancer (CRC) is largely preventable through lifestyle changes targeting diet and physical activity. Colonoscopy offers a timely opportunity to promote awareness of CRC risk factors. PRECÔTION is a digital intervention using motivational and community-based strategies to encourage preventive actions based on individual risk level.
Objectives: This study assessed its feasibility, acceptability, adherence, and preliminary impact on lifestyle behaviors and CRC risk awareness.
Methods: PRECÔTION was a single-center, prospective, single-arm interventional study. Participants with a normal colonoscopy result were assigned to one of three risk groups (low, moderate, high) based on physical activity (IPAQ), dietary behavior (WCRF), and BMI. Over six months, all participants received personalized digital support (videos, podcasts, interactive app) using motivational strategies. Group physical activity sessions and health education workshops were offered depending on risk level. High-risk participants also received individual motivational coaching and a connected watch to track daily steps. Initial and final assessments measured behavioral changes and satisfaction. Results: Between October 2022 and October 2023, 90 participants were enrolled (n=33 low risk, n=21 moderate risk, n=36 high risk), with a mean age of 53 years and 69% women. The intervention showed good feasibility: 60% of participants who completed follow-up engaged with all tools provided, with higher adherence in moderate and high-risk groups (62%) compared to low-risk (56%). Early outcomes were promising, with notable improvements in lifestyle scores (WCRF: +0.44 and +1.12) and physical activity levels (+5.09 and +7.45) in moderate and high-risk groups, respectively. Overall, 38.6% of participants improved their WCRF score by at least one point—rising to 61.9% in the high-risk group—highlighting the program’s potential to drive meaningful behavior change.
Conclusion: The PRECÔTION study demonstrates that a personalized, risk-based digital intervention is both feasible and well accepted among individuals undergoing colonoscopy. The program showed good levels of commitment and promising behavioral improvements, particularly in individuals with unhealthy lifestyles. These findings suggest that colonoscopy can serve as a strategic entry point for initiating lifestyle change. Scaling up this approach through a randomized controlled trial could validate its effectiveness in reducing modifiable risk factors and ultimately contribute to lowering the incidence of preventable CRC.