Background Poor UK lung cancer survival rates may, in part, be due to late diagnosis. Objectives To evaluate the effectiveness of a mixedmethod community-based social marketing intervention on lung cancer diagnoses. Methods A public awareness campaign in conjunction with brief intervention training in general practices was piloted in six localities with a high lung cancer incidence. End points were self-reported awareness of lung cancer symptoms; intention to seek healthcare; chest x-ray referral rates in primary care; secular trends in the incidence of lung cancer and stage at diagnosis, compared before and after the intervention. Results 21% (128/600) (95% CI 18% to 25%) of the targeted population recalled something about the campaign. Compared with a responder in the control area, the odds of a responder in the intervention area saying that they would visit their general practitioner and request a chest x-ray for a cough was 1.97 times (95% CI 1.18 to 3.31, p¼0.01). Primary care chest x-ray referral rates increased by 20% in the targeted practices in the year following the intervention compared with a 2% fall in the control practices. The difference was highly significant, with an incidence rate ratio of 1.22 (95% CI 1.12 to 1.33, p¼0.001). There was a 27% increase in lung cancer diagnoses in the intervention area compared with a fall in the control area. The incidence rate ratio was 1.42 (95% CI 0.83 to 2.44 p¼0.199). Conclusion This is encouraging early evidence that an awareness and early recognition initiative may facilitate lung cancer diagnosis.

We report a cohort study of survival of patients with lung cancer presenting to a single multidisciplinary team between 1997 and 2011, according to symptoms at presentation. The overall median survival of the 3800 lung cases was 183 days (95% CI 171 to 195). There was a statistically significant difference in survival between the 12 symptom groups identified both without and with adjustment for the prognostic variables of age, gender and histology (P<0.001). Compared with the cough-alone symptom group, the risks of dying or HRs were significantly higher for the groups presenting with breathlessness (HR 1.86, 95% CI 1.54 to 2.24, n=359), systemic symptoms (HR 1.91, 95% CI 1.48 to 2.45, n=95), weight loss (HR 2.46, 95% CI 1.90 to 3.18, n=106), chest pain (HR 1.96, 95% CI 1.56 to 2.45, n=159), cough with breathlessness (HR 1.59 95% CI 1.28 to 1.98, n=177), neurological symptoms (HR 3.07, 95% CI 2.45 to 3.84, n=155) and other symptom combinations (HR 2.05, 95% CI 1.75 to 2.40, n=1963). Cough may deserve particular prominence in public health campaigns.

647021Word Count (excluding references) = 2,250Key Words: Lung Cancer, Early Diagnosis, Screening, Social Marketing Abstract Lung cancer is a major global health burden with high incidence rates but poor long-term survival. Currently the majority of cases are diagnosed at an advanced stage when surgical resection is not feasible. Screening for lung cancer has been a major focus of research for the last 40 years. Despite this there is still a lack of evidence to promote its use outside of a clinical trial. More recently interest has focussed on promoting earlier recognition of symptomatic disease among both the general public and primary care physicians, in order to encourage more timely investigation and referral to secondary care. The hope is that this approach may increase the proportion of disease identified in the early stages, allowing more surgical resections and improved 5-year survival rates. This paper provides an overview of the current evidence base regarding early diagnosis of lung cancer and provides some examples of innovations to promote this. 2Background

oropharyngeal dysphagia and dysphonia. She was supported to use a left head turn swallow strategy to reduce the risk of aspiration. In addition vocal hygiene advice and education was provided, aiming to prevent vocal strain. Conclusion: Patient X benefited from assessment and intervention by a range of SC therapists which may have prevented aspiration pneumonia, minimised her weight loss and increased her functional independence thus having a significant impact on her quality of life. In many centres access to SC services may result in a high appointment burden and non-specialist intervention. Providing these services as part of a one stop MDT clinic prevented additional appointments and ensured effective communication between the MDT, so that medical and supportive goals were aligned. It can be argued this should be gold standard care for all lung cancer patients. To support this argument more robust clinical outcomes and patient experience data needs to be collected.Background: Lung cancer is one of the most prevalent cancers worldwide and pain is its most common symptom. Pain can be brought about by several causes including local invasion of chest structures, metastatic disease or can also be a consequence of treatment. An active multidisciplinary approach is required to manage pain in patients with lung cancer Method: It is a cross-sectional study of 166 patients with lung cancer. We used the BPI "Brief pain inventory``to assess pain prevalence, intensity and impact on quality of life. Adequacy of pain management was evaluated by the Pain Management Index (PMI) Result: We interviewed 166 patients with bronchogenic carcinoma, 163 men and 3 women. 116 with adenocarcinoma and 50 with epidermoid carcinoma. 80 (42.2%) of our patients have pain. Among them, 7 report low pain and 73 moderate to severe pain (91%). 149 (89,7%) patients have metastasis. The association between the intensity of pain and metastasis was statistically significant (p<0,001). 21 patients (26.2%) are treated with antalgic. 18 with the second level and 3 with the third level. The Pain Management Index (PMI) is negative in 63 patients (81.2%). There is also a statically significant correlation between the intensity of pain and the degradation of each quality of life parameter. Conclusion: Pain management still remains a challenge. This deficiency is due to the inadequate medical training and the unavailability of most third level of analgesics in ambulatory prescription.Background: Lung cancer is one of the most common cancers in the world in terms of both incidence and mortality. In patients with advanced lung cancer, the progressive decline in nutritional and functional status -particularly unintended weight loss -has been strongly associated with reduced physical functioning, poor tolerance to anticancer therapy, decreased quality of life, and poor prognosis and survival. The aim of the present study was to assess and characterize the nutritional status of patients with lung cancer at the moment of diagnosis. Method: A retrospective study wa...

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