Background:National campaigns focusing on key symptoms of bowel and lung cancer ran in England in 2012, targeting men and women over the age of 50 years, from lower socioeconomic groups.Methods:Data from awareness surveys undertaken with samples of the target audience (n=1245/1140 pre-/post-bowel campaign and n=1412/1246 pre-/post-lung campaign) and Read-code data extracted from a selection general practitioner (GP) practices (n=355 for bowel and n=486 for lung) were analysed by population subgroups.Results:Unprompted symptom awareness: There were no significant differences in the magnitude of shift in ABC1 vs C2DE groups for either campaign. For the bowel campaign, there was a significantly greater increase in awareness of blood in stools in the age group 75+ years compared with the 55–74 age group, and of looser stools in men compared with women. Prompted symptom awareness: Endorsement of ‘blood in poo' remained stable, overall and across different population subgroups. Men showed a significantly greater increase in endorsement of ‘looser poo' as a definite warning sign of bowel cancer than women. There were no significant differences across subgroups in endorsement of a 3-week cough as a definite warning sign of lung cancer. GP attendances: Overall, there were significant increases in attendances for symptoms directly linked to the campaigns, with the largest percentage increase seen in the 50–59 age group. For the bowel campaign, the increase was significantly greater for men and for practices in the most-deprived quintile, whereas for lung the increase was significantly greater for practices in the least-deprived quintile.Conclusions:The national bowel and lung campaigns reached their target audience and have also influenced younger and more affluent groups. Differences in impact within the target audience were also seen. There would seem to be no unduly concerning widening in inequalities, but further analyses of the equality of impact across population subgroups is warranted.

than likely, the success of surufatinib is attributable to both its novel mechanism of action and favourable business decisions around its development. In addition, we do not yet know how surufatinib will fit into the complex treatment algorithm for NETs. Evidence regarding sequence of therapies is a crucial need in the field, although might be impractical to study in prospective clinical trials. We also need to study mechanisms of resistance to tyrosine kinase inhibitors, develop and validate predictive biomarkers, understand reasons for heterogeneity in objective response, and identify better quantitative radiological response criteria in the setting of angiogenesis inhibition. Last, but not least, we must also keep patients with NETs at the core of how we think about optimal treatment strategies. Given the chronicity of well differentiated NETs, these patients will experience an accumulation of toxicities over years that include non-trivial drug side-effects, particularly with tyrosine kinase inhibitors.PLK reports receiving research funding to her institution from Advanced Accelerator Applications, Brahms (Thermo-Fisher Scientific), Ipsen, Lexicon Pharmaceuticals, and Xencor; and reports serving on scientific advisory board meetings for and receiving honorarium from Advance Accelerator Applications and Ipsen.

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HighlightsOn average, people endorsed three barriers that would put them off seeing a GP.Women, younger people and more deprived groups were more likely to endorse barriers.Service-related barriers endorsed more than barriers related to GP–patient relations.Endorsement of not wanting to be seen making a fuss reveals more social element.The results suggest that there may be additional barriers influencing patient behaviour.

Background Lung cancer is the leading cause of cancer mortality in Wales. We conducted a before-and afterstudy to evaluate the impact of a four-week mass media campaign on awareness, presentation behaviour and lung cancer outcomes. Methods Population-representative samples were surveyed for cough symptom recall/recognition and worry about wasting doctors' time pre-campaign (June 2016; n=1,001) and post-campaign (September 2016; n=1,013). GP cough symptom visits, urgent suspected cancer (USC) referrals, GP-ordered radiology, new lung cancer diagnoses and stage at diagnosis were compared using routine data during the campaign (July-August 2016) and corresponding control (July-August 2015) periods. Results Increased cough symptom recall (p<0.001), recognition (p<0.001) and decreased worry (p<0.001) were observed. GP visits for cough increased by 29% in the target 50+ age-group during the campaign (p<0.001) and GP-ordered chest X-rays increased by 23% (p<0.001). There was no statistically significant change in USC referrals (p=0.82), new (p=0.70) or early stage (p=0.27) diagnoses, or in routes to diagnosis. Conclusion Symptom awareness, presentation and GP-ordered chest x-rays increased during the campaign, but did not translate into increased USC referrals or clinical outcomes changes. Short campaign duration and follow up, and the small number of new lung cancer cases observed may have hampered detection effects.