An evaluation of the impact of large-scale interventions to raise public awareness of a lung cancer symptom

L Ironmonger, E Ohuma, N Ormiston-Smith, C Gildea, C S Thomson, M D Peake, L Ironmonger, E Ohuma, N Ormiston-Smith, C Gildea, C S Thomson, M D Peake

Abstract

Introduction: Long-term lung cancer survival in England has improved little in recent years and is worse than many countries. The Department of Health funded a campaign to raise public awareness of persistent cough as a lung cancer symptom and encourage people with the symptom to visit their GP. This was piloted regionally within England before a nationwide rollout.

Methods: To evaluate the campaign's impact, data were analysed for various metrics covering public awareness of symptoms and process measures, through to diagnosis, staging, treatment and 1-year survival (available for regional pilot only).

Results: Compared with the same time in the previous year, there were significant increases in metrics including: public awareness of persistent cough as a lung cancer symptom; urgent GP referrals for suspected lung cancer; and lung cancers diagnosed. Most encouragingly, there was a 3.1 percentage point increase (P<0.001) in proportion of non-small cell lung cancer diagnosed at stage I and a 2.3 percentage point increase (P<0.001) in resections for patients seen during the national campaign, with no evidence these proportions changed during the control period (P=0.404, 0.425).

Conclusions: To our knowledge, the data are the first to suggest a shift in stage distribution following an awareness campaign for lung cancer. It is possible a sustained increase in resections may lead to improved long-term survival.

References

    1. Abdel-Rahman M, Stockton D, Rachet B, Hakulinen T, Coleman MP. What if cancer survival in Britain were the same as in Europe: how many deaths are avoidable. Br J Cancer. 2009;101:S115–S124.
    1. Athey VL, Suckling RJ, Tod AM, Walters SJ, Rogers TK. Early diagnosis of lung cancer: evaluation of a community-based social marketing intervention. Thorax. 2012;67:412–417.
    1. Austoker J, Bankhead C, Forbes LJ, Atkins L, Martin F, Robb K, Wardle J, Ramirez AJ. Interventions to promote cancer awareness and early presentation: systematic review. BJC. 2009;101:S31–S39.
    1. Blanchard D, Erblich J, Montgomery GH, Bovbjerg DH. Read all about it: the over-representation of breast cancer in popular magazines. Prev Med. 2002;35 (4:343–348.
    1. Cancer Research UK 2014. Lung Cancer Statistics (accessed February 2014).
    1. Clarke JN. A comparison of breast, testicular and prostate cancer in mass print media (1996-2001) Soc Sci Med. 2004;59 (3:541–551.
    1. Coleman MP, Forman D, Bryant H, Butler J, Rachet B, Maringe C, Nur U, Tracey E, Coory M, Hatcher J, McGahan CE, Turner D, Marrett L, Gjerstorff ML, Johannesen TB, Adolfsson J, Lambe M, Lawrence G, Meechan D, Morris EJ, Middleton R, Steward J, Richards MA, ICBP Module 1 Working Group Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet. 2011;377:127–138.
    1. Corazziari I, Quinn M, Capocaccia R. Standard cancer patient population for age standardising survival ratios. Eur J Cancer. 2004;40 (15:2307–2316.
    1. Elliss-Brookes L, McPhail S, Ives A, Greenslade M, Shelton J, Hiom S, Richards M. Routes to Diagnosis for cancer—determining the patient journey using multiple routine datasets. Br J Cancer. 2012;107:1220–1226.
    1. Hamilton W, Peters TJ, Round A, Sharp D. What are the clinical features of a lung cancer before diagnosis is made? A population-based case-control study. Thorax. 2005;60:1059–1065.
    1. Health and Social Care Information Centre (HSCIC) 2012. Quality and Outcomes Framework – 2011–12, Practice level. Available at (accessed October 2014).
    1. Health & Social Care Information Centre (HSCIC) 2013. The National Lung Cancer Audit (NLCA) Data Manual, Version 3.1.5. Available at (accessed February 2014).
    1. Healthcare Quality Improvement Partnership 2014. The Healthcare Quality Improvement Partnership's website homepage. (accessed February 2014).
    1. Holmberg L, Sandin F, Bray F, Richards M, Spicer J, Lambe M, Klint A, Peake M, Strand TE, Linklater K, Robinson D, Møller H. National comparisons of lung cancer survival in England, Norway and Sweden 2001-2004: differences occur early in follow-up. Thorax. 2010;65:436–441.
    1. Imperatori A, Harrison RN, Leitch DN, Rovera F, Lepore G, Dionigi G, Sutton P, Dominioni L. Lung cancer in Teesside (UK) and Varese (Italy): a comparison of management and survival. Thorax. 2006;61:232–239.
    1. Mayden 2014. Mayden's website homepage. (accessed February 2014).
    1. National Institute for Health and Care Excellence (NICE) 2005. Referral Guidelines for suspected cancer. Available from (accessed February 2014).
    1. NHS England 2014. Cancer Waiting Times. (accessed February 2014).
    1. NHS England 2014. Diagnostic Imaging Dataset. (accessed February 2014).
    1. Oken MM, Hocking WG, Kvale PA, Andriole GL, Buys SS, Church TR, Crawford ED, Fouad MN, Isaacs C, Reding DJ, Weissfeld JL, Yokochi LA, O'Brien B, Ragard LR, Rathmell JM, Riley TL, Wright P, Caparaso N, Hu P, Izmirlian G, Pinsky PF, Prorok PC, Kramer BS, Miller AB, Gohagan JK, Berg CD, PLCO Project Team Screening by chest radiograph and lung cancer mortality: the Prostate, Lung, Colorectal, and Ovarian (PLCO) randomized trial. JAMA. 2011;306 (17:1865–1873.
    1. Quaresma M, Coleman MP, Rachet B.2014Forty-year trends in an index of survival for all cancers combined, and in age-sex-adjusted survival for each cancer: a population-based study in England and Wales, 1971–2011 Lancet Oncol(in press).
    1. Riaz SP, Lüchtenborg M, Jack RH, Coupland VH, Linklater KM, Peake MD, Møller H. Variation in radical resection for lung cancer in relation to survival: population-based study in England 2004–2006. Eur J Cancer. 2012;48:54–60.
    1. Shim J, Brindle L, Simon M, George S. A systematic review of symptomatic diagnosis of lung cancer. Fam Pract. 2014;31 (2:137–148.
    1. Smith SM, Campbell NC, MacLeod U, Lee AJ, Raja A, Wyke S, Ziebland SB, Duff EM, Ritchie LD, Nicolson MC. Factors contributing to the time taken to consult with symptoms of lung cancer: a cross-sectional study. Thorax. 2009;64:523–531.
    1. Sobin LH, Gospodarowicz MK, Wittekind C.2009TNM classification of malignant tumours7th edn.Union for International Cancer Control, Wiley-Blackwell: Oxford
    1. StataCorp . Stata Statistical Software: Release 11. StataCorp LP: College Station, TX; 2009.
    1. Stubbings S, Robb K, Waller J, Ramirez A, Austoker J, Macleod U, Hiom S, Wardle J. Development of a measurement tool to assess public awareness of cancer. Br J Cancer. 2009;101:S13–S17.
    1. TNS BMRB 2014. TNS BMRB's website homepage. (accessed February 2014).
    1. Thackeray R, Burton SH, Giraud-Carrier C, Rollins S, Draper CR. Using Twitter for breast cancer prevention: an analysis of breast cancer awareness month. BMC Cancer. 2013;13:508.
    1. Treasure T, Russell C, Morton D, Macbeth F, Utley M. Surgical resection of lung cancer England: more operations but no trials to test their effectiveness. Thorax. 2012;67:759–761.
    1. Walters S, Maringe C, Coleman MP, Peake MD, Butler J, Young N, Bergström S, Hanna L, Jakobsen E, Kölbeck K, Sundstrøm S, Engholm G, Gavin A, Gjerstorff ML, Hatcher J, Johannesen TB, Linklater KM, McGahan CE, Steward J, Tracey E, Turner D, Richards MA, Rachet B, ICBP Module 1 Working Group Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the United Kingdom: a population-based study, 2004-2007. Thorax. 2013;68:551–564.

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