Objective To investigate the proactive preventive behaviors among high-risk individuals of digestive system cancer and their influencing factors.Methods A total of 322 high-risk individuals,who completed gastroscopy and/or colonoscopy at Gastroenterology Endoscopy Center of Shanghai Tenth People's Hospital from June to August 2022,were selected by convenience sampling method.A questionnaire survey on general information was conducted and the Proactive Prevention Behavior Scale in the Population at High Risk of Digestive System Cancer(DSC-PPBS)was assessed.The levels of proactive preventive behaviors and their influencing factors were analyzed.Results The proactive preventive behavior total score of 322 participants was(83.63±10.89),reaching an excellent level.Univariate analysis showed that there were significant difference in DSC-PPBS total scores between individuals with and without smoking history,between those with and without drinking history(P<0.05);age,gender,family history,smoking history,drinking history,and gastroenteroscopy experience were significantly correlated with the scores of proactive preventive behaviors(P<0.05).Linear regression analysis showed that the regression model was significantly significance(F=5.568,P=0.000),and the independent variables explained 6.6%of the variation in preventive active behavior;the age,family history,smoking history,and gastroenteroscopy experience had a significant effect on preventive active behavior(P<0.05).Conclusion The proactive ability to prevent cancer among people at high risk of digestive system cancers is quite good in this study.People with older age,a family history of cancer,a history of smoking and experiencing gastroenteroscopy are more proactive in adopting cancer prevention behaviors.