An evaluation of a national mass media campaign to raise public awareness of possible lung cancer symptoms in England in 2016 and 2017

Abstract

Background. A two-phase ‘respiratory symptoms’ mass media campaign was conducted in 2016 and 2017 in England raising awareness of cough and worsening shortness-of-breath as symptoms warranting a GP visit. Method. A prospectively planned pre-post evaluation was done using routinely collected data on 15 metrics, including: GP attendance, GP referral, emergency presentations, cancers diagnosed (5 metrics), cancer stage, investigations (2 metrics), outpatient attendances, inpatient admissions, major lung resections and one year survival. The primary analysis compared 2015 with 2017. Trends in metrics over the whole period were also considered. The effects of the campaign on awareness of lung cancer symptoms were evaluated using bespoke surveys. Results. There were small favourable statistically significant and clinically important changes over two years in 11 of the 15 metrics measured, including a 2.11% (95% CI 1.02-3.20: p<0.001) improvement in the percentage of lung cancers diagnosed at an early stage. However, these changes were not accompanied by increases in GP attendances. Furthermore, the time trends showed a gradual change in the metrics rather than steep changes occurring during or after the campaigns. Conclusion. There were small positive changes in most metrics relating to lung cancer diagnosis after this campaign. However, the pattern over time challenges whether the improvements are wholly attributable to the campaign. Given the importance of education on cancer in its own right, raising awareness of symptoms should remain important. However further research is needed to maximise effect on health outcomes.