BMJ Open · Oct 29, 2026

Effectiveness of physical activity and sedentary behaviour interventions delivered following cancer screening or suspected cancer referral: a systematic review and meta-analysis protocol

By Yerrakalva D, Gregory B

INTRODUCTION: Higher levels of physical activity (PA) and lower levels of sedentary behaviour are associated with reduced cancer incidence and premature mortality. However, interventions to increase PA and reduce sedentary time often achieve modest and short-term behaviour change. Significant health events may represent ‘teachable moments’ when individuals are particularly receptive to behaviour change. Cancer screening and referral for investigation of suspected cancer may provide such opportunities particularly following a negative screening result or non-cancer diagnosis. However, the effectiveness of PA and sedentary interventions delivered during these clinical pathways has not been systematically evaluated. METHODS AND ANALYSIS: This systematic review and meta-analysis protocol has been developed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidance. MEDLINE (Ovid), Embase (Ovid), Web of Science Core Collection and the Cochrane Central Register of Controlled Trials will be searched from January 2008 onwards, supplemented by searches of relevant trial registries and reference lists. Eligible studies will include randomised and cluster-randomised controlled trials involving adults (≥18 years) who have undergone cancer screening or have been referred for investigation of suspected cancer and subsequently received a non-cancer diagnosis. Interventions must explicitly aim to increase PA and/or reduce sedentary behaviour and be delivered at or following cancer screening or following referral for suspected cancer and receipt of a non-cancer diagnosis. Primary outcomes will be change in objectively measured PA and change in objectively measured sedentary time. Two reviewers will independently screen studies, extract data and assess risk of bias using the appropriate Risk of Bias 2 tool for individually randomised or cluster-randomised trials. Intervention content will be coded using the Behaviour Change Technique Taxonomy. Where appropriate, random-effects meta-analysis will be conducted. Secondary objectives will examine intervention functions and behaviour change techniques in relation to the magnitude and direction of effects and compare mobile health (mHealth) with non-mHealth interventions. Certainty will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach (GRADE). ETHICS & DISSEMINATION: Ethics review was not required as this is a systematic review protocol. Findings will be disseminated through peer-reviewed publication, conference presentations and engagement with relevant cancer prevention and public health stakeholders. PROSPERO REGISTRATION NUMBER: CRD420261481574.

doi.org/10.1136/bmjopen-2026-127499 Open access PubMed 42957305 Interventions