Evaluation of a national lung cancer symptom awareness campaign in Wales

McCutchan, Grace; Smits, Stephanie; Ironmonger, Lucy; Slyne, Ciarán; Boughey, A.; Moffat, Jodie; Thomas, R. S.; Huws, Dyfed Wyn; Brain, Kate

doi:10.1038/s41416-019-0676-2

Cited by 10 publications

(12 citation statements)

References 22 publications

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“… 19 Conflation with COVID-19 symptoms could mean that potential lung cancer symptoms are ignored, and healthcare services avoided. In deprived and smoking populations where fatalism and stigma associated with lung cancer prevail, 20 , 21 there may be considerable reluctance to present in primary care with lung or non-specific systemic symptoms that could be viewed as wasting scarce NHS resources.…”

Section: Patient Awareness and Help-seeking For Potential Lung Cancer Symptomsmentioning

confidence: 99%

“…In the COVID-19 recovery phase and subsequent second wave, public health and cancer awareness interventions will be important to facilitate early symptomatic presentation of lung cancer. Prior to COVID-19, evaluations of the mass-media Be Clear on Cancer ‘cough’ campaigns have shown increased lung symptom awareness and primary care presentations 21 , 26 , 27 and stage shift. 26 Evidence-based interventions are needed to address pre-existing and COVID-specific barriers to help-seeking for lung cancer symptoms.…”

Section: Patient Awareness and Help-seeking For Potential Lung Cancer Symptomsmentioning

confidence: 99%

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COVID-19 and the multidisciplinary care of patients with lung cancer: an evidence-based review and commentary

et al. 2021

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Delivering lung cancer care during the COVID-19 pandemic has posed significant and ongoing challenges. There is a lack of published COVID-19 and lung cancer evidence-based reviews, including for the whole patient pathway. We searched for COVID-19 and lung cancer publications and brought together a multidisciplinary group of stakeholders to review and comment on the evidence and challenges. A rapid review of the literature was undertaken up to 28 October 2020, producing 144 papers, with 113 full texts screened. We focused on new primary data collection (qualitative or quantitative evidence) and excluded case reports, editorials and commentaries. Following exclusions, 15 published papers were included in the review and are summarised. They included one qualitative paper and 14 quantitative studies (surveys or cohort studies), with a total of 2295 lung cancer patients data included (mean study size 153 patients; range 7–803). Review of current evidence and commentary included awareness and help-seeking; lung cancer screening; primary care assessment and referral; diagnosis and treatment in secondary care, including oncology and surgery; patient experience and palliative care. Cross-cutting themes and challenges were identified using qualitative methods for patients, healthcare professionals and service delivery, with a clear need for continued studies to guide evidence-based decision-making.

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Section: Patient Awareness and Help-seeking For Potential Lung Cancer Symptomsmentioning

confidence: 99%

Section: Patient Awareness and Help-seeking For Potential Lung Cancer Symptomsmentioning

confidence: 99%

COVID-19 and the multidisciplinary care of patients with lung cancer: an evidence-based review and commentary

et al. 2021

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“…Elsewhere worldwide, similar mass media campaigns include the skin cancer awareness campaigns, 10 bowel screening campaign, 11 “Find Cancer Early” community education campaign and community‐based symptom awareness and general practice‐based educational interventions 12 in Australia; the “Detect Cancer Early” Programme in Scotland 13 ; the lung cancer awareness campaign, 14,15 and the bowel 16 and cervical 17 screening programmes in Wales; the “Be Cancer Aware” campaign in Northern Ireland 18 ; and oral cancer awareness campaign in Germany 19 . However, BCoC in England is an exemplar given the large number and range of coordinated campaigns and their comprehensive evaluation.…”

Section: Introductionmentioning

confidence: 99%

Reviewing the impact of 11 national Be Clear on Cancer public awareness campaigns, England, 2012 to 2016: A synthesis of published evaluation results

Lai

Mak

Bright

et al. 2020

Intl Journal of Cancer

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The Be Clear on Cancer (BCoC) campaigns have run in England since 2010. They aim to raise awareness of possible cancer symptoms, encouraging people to consult a general practice with these symptoms. Our study provides an overview of the impact of 11 national campaigns, for bowel, lung, bladder and kidney, breast and oesophago‐gastric cancers. We synthesised existing results for each campaign covering seven clinical metrics across the patient pathway from primary care attendances to one‐year net survival. For each metric, “before” and “after” periods were compared to assess change potentially related to the campaign. Results show that primary care attendances for campaign‐related symptoms increased for 9 of 10 campaigns and relevant urgent referrals for suspected cancer increased above general trends for 9 of 11 campaigns. Diagnostic tests increased for 6 of 11 campaigns. For 7 of 11 campaigns, there were increases in cancer diagnoses resulting from an urgent referral for suspected cancer. There were sustained periods where more cancers were diagnosed than expected for 8 of 10 campaigns, with higher than expected proportions diagnosed at an early stage for sustained periods for 4 of 10 campaigns. There was no impact on survival. In summary, there is evidence that the BCoC campaigns impact help‐seeking by patients and referral patterns by general practitioners, with some impact on diagnosis (incidence and stage). There was no clear evidence of impact on survival.

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“… 127 , 133 The Behaviour Change Wheel 128 and Normalization Process Theory 134 are some of the many theories and frameworks that have been adopted to understand and assess implementation in early cancer diagnosis programs in the United Kingdom, Denmark, and Australia. 135 - 140 …”

Section: Design and Implementationmentioning

confidence: 99%

“…Although some randomized control trials have been conducted, 120 , 142 the majority of early diagnosis programs are natural experiments and so evaluations more often take other forms such as before and after designs and interrupted time series analysis, commonly involving mixed-methods research. 22 , 25 , 27 , 40 , 135 , 143 - 145 …”

Section: Monitoring and Evaluationmentioning

confidence: 99%

Conceptual Framework to Guide Early Diagnosis Programs for Symptomatic Cancer as Part of Global Cancer Control

Koo

Unger‐Saldaña

Mwaka

et al. 2021

JCO Global Oncology

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Diagnosing cancer earlier can enable timely treatment and optimize outcomes. Worldwide, national cancer control plans increasingly encompass early diagnosis programs for symptomatic patients, commonly comprising awareness campaigns to encourage prompt help-seeking for possible cancer symptoms and health system policies to support prompt diagnostic assessment and access to treatment. By their nature, early diagnosis programs involve complex public health interventions aiming to address unmet health needs by acting on patient, clinical, and system factors. However, there is uncertainty regarding how to optimize the design and evaluation of such interventions. We propose that decisions about early diagnosis programs should consider four interrelated components: first, the conduct of a needs assessment (based on cancer-site–specific statistics) to identify the cancers that may benefit most from early diagnosis in the target population; second, the consideration of symptom epidemiology to inform prioritization within an intervention; third, the identification of factors influencing prompt help-seeking at individual and system level to support the design and evaluation of interventions; and finally, the evaluation of factors influencing the health systems’ capacity to promptly assess patients. This conceptual framework can be used by public health researchers and policy makers to identify the greatest evidence gaps and guide the design and evaluation of local early diagnosis programs as part of broader cancer control strategies.

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Evaluation of a national lung cancer symptom awareness campaign in Wales

Cited by 10 publications

References 22 publications

COVID-19 and the multidisciplinary care of patients with lung cancer: an evidence-based review and commentary

COVID-19 and the multidisciplinary care of patients with lung cancer: an evidence-based review and commentary

Reviewing the impact of 11 national Be Clear on Cancer public awareness campaigns, England, 2012 to 2016: A synthesis of published evaluation results

Conceptual Framework to Guide Early Diagnosis Programs for Symptomatic Cancer as Part of Global Cancer Control

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