The fourth most common form of cancer in Sweden is colorectal cancer. The disease can be linked to both heredity and environmental factors, and to individual lifestyle factors such as tobacco smoking, obesity, alcohol consumption, physical inactivity and eating habits (high intake of red and processed meat; low intake of fruit, vegetables, fibers and calcium). The link to lifestyle means that individuals can reduce their risk of colorectal cancer by changing their habits.
This opportunity to influence one’s own risk naturally requires that one is aware of the disease and informed about the lifestyle-related factors. But what does the public know about colorectal cancer? How do they prefer that risk information about lifestyle-related factors be communicated? And what can motivate them to change their habits? Well-designed risk communication requires knowledge of these issues.
An interview study investigated the general public’s knowledge of colorectal cancer and views on risk communication about the disease. They also examined what the participants thought would motivate them to change their lifestyle. The lead author is Erica Sundell, who, together with four co-authors, describes the study’s design and results in an article in BMC Public Health. They found that the participants generally knew very little about colorectal cancer and that most had never encountered information about specific risk factors. The knowledge gap was instead filled by stereotypes about who is at risk of developing colorectal cancer, and by guesses about how healthy habits can outweigh less healthy ones. Such intuitions can lead to incorrect assessments of one’s own risk and how it is best managed. Colorectal cancer therefore needs to be made more visible, but how?
Something that emerged from the interviews was that specific risk factors for colorectal cancer did not necessarily motivate the participants to change their habits. The risk of colorectal cancer was only one of several factors that they balanced, and they were prepared to take certain risks in order to live a good life here and now. It also turned out that although some believed that a reduced risk of colorectal cancer could motivate them to change their habits, others said that what could motivate them to live healthier was a reduced risk of cardiovascular disease, better health in general, and greater well-being.
Another interview result was that the participants wanted information that explained how lifestyle-related factors can increase the risk of colorectal cancer. Several found it strange that smoking can affect the risk of cancer in the colon and rectum and not just in the lungs. Other risk factors also seemed intuitively unlikely. The interviewees therefore wanted information that not only listed risk factors but also provided a deeper understanding of the mechanisms, at least when the risk factors were spontaneously perceived as unlikely. At the same time, the messages need to be simple and not overloaded with information. Furthermore, the participants believed that positive information that emphasizes what you gain from changing your habits is more effective than negative information that spreads fear and guilt by focusing primarily on risks associated with your lifestyle.
The study yielded many interesting results, for example about where and when people are most receptive to risk information, and how responsibility can be shared between the individual and society. You can find the article here: Colorectal cancer risk: stereotypical assumptions and competing values – a qualitative study with the general public.
In their conclusion, the authors emphasize that colorectal cancer needs to be made visible in order to counteract preconceived notions about the disease. There is a clear need to make it understandable how certain lifestyle habits can affect the risk of colorectal cancer, as the connections can sometimes seem unlikely. It should also be borne in mind that people may have different motives for living healthier, and that they may make different trade-offs between quality of life and reduced risk. Finally, the authors emphasize that risk communication about colorectal cancer should be nuanced and non-judgmental, especially considering that the recommendations do not guarantee protection against cancer.
Written by…
Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.
Sundell, E., Hedström, M., Fahlquist, J.N. et al. Colorectal cancer risk: stereotypical assumptions and competing values – a qualitative study with the general public. BMC Public Health 26, 706 (2026). https://doi.org/10.1186/s12889-026-26737-2
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