Following a campaign urging people with a persistent cough to visit their doctor, there has been a surge of lung cancers diagnosed at an early enough stage for the patients to receive surgery which could be curative.
More than 3,000* extra referrals were made by GPs according to an analysis of the campaign results led by Cancer Research UK published in the British Journal of Cancer.
The work was led by Dr Mick Peake, consultant in respiratory medicine at University Hospitals of Leicester and senior lecturer at the University of Leicester. Dr Peake is based at the Institute for Lung Health established by the Senate of the University of Leicester to act as an umbrella for all those engaged in respiratory research and clinical development in Leicester.
This is an increase of more than 30 per cent in referrals during the months surrounding the campaign, May to July 2012, compared with the same three month period the year before.
Most importantly, in the months surrounding the powerful Be Clear on Cancer campaign around 700 extra patients were diagnosed with lung cancer – many at an early stage – and nearly 300 more patients received surgery**.
And a survey conducted after the campaign involving more than 1,100 people showed that, when prompted, 33 per cent were aware that a cough lasting more than three weeks was a definite warning sign of lung cancer compared with only 18 per cent before the campaign***.
Experts believe that this kind of awareness campaign can ?lead to earlier diagnosis which in turn gives patients a better chance of successful surgery, follow up treatment and prolonged survival.
An analysis of the figures showed that the referrals resulted from an average of six extra patient appointments for a cough per week per GP practice****.
The Public Health England campaign which is supported by Cancer Research UK, NHS England and the Department of Health, ran throughout England from May-June 2012. People were urged to go to the GP if they had a cough lasting longer than three weeks.
Harpal Kumar, Cancer Research UK’s chief executive said: “This proves just how successful a simple campaign alerting people to be vigilant about persistent coughing can be. The sooner people recognise changes in their bodies and go to their GP for a check-up, the better their chances if it does turn out to be cancer.
“Earlier diagnosis combined with pioneering research means we can make real progress in treating lung cancer – a devastating disease that has killed millions of people.”
Dr Peake, lead author of the paper, said: “I can honestly say that this campaign has achieved more than I ever expected. We were surprised to see so many more patients diagnosed with lung cancer at an early stage of their disease and then to see that being translated into a significant increase in the number of patients going on to have potentially curative surgery is hugely encouraging. If maintained, this effect could really result in a fall in the number of patients who die from lung cancer in the longer term.”
Sean Duffy, national clinical Director for Cancer at NHS England, said: “Helping people to understand what symptoms to worry about, and encouraging them to step forward early, is key to making sure people get the treatment they need at the earliest possible stage. The impact of this campaign on referrals for lung cancer patients is hugely encouraging and reflects what we’re seeing across the board – the number of people being referred and treated for cancer is at an all-time high, and as a result the NHS is helping more people than ever survive.”
Professor Kevin Fenton, Director of Health and Wellbeing at Public Health England, said: “Lung cancer is England’s biggest cancer killer, causing around 28,100 deaths each year. Early diagnosis and treatment is crucial, as patients diagnosed at an early stage are five times more likely to survive lung cancer for at least five years than those diagnosed at a later stage.
“Statistics like this demonstrate why initiatives that seek to increase symptom awareness levels – like our Be Clear on Cancer Lung Cancer Campaign – are incredibly significant in the battle against this form of cancer.”
Ironmonger, L et al. An evaluation of the impact of large scale interventions to raise public awareness of a lung cancer symptom. British Journal of Cancer (2014) DOI: 10.1038/bjc.2014.596
*The new analysis led by Cancer Research UK: ‘An evaluation of the impact of large scale interventions to raise public awareness of a lung cancer symptom’ calculated that between May and July in 2012 13,849 urgent referrals were made by GPs for suspected lung cancer. This compares with 10,504 referrals for the same period in 2011 – equivalent to an increase of 31.8 per cent. Analysis was provided by Public Health England’s National Cancer Intelligence Network, using data from NHS England’s National Cancer Waiting Times Monitoring Database.
** In England, there was a statistically significant increase of 9.1% in the number of lung cancer cases diagnosed in patients first seen for lung cancer during the months surrounding the Be Clear on Cancer lung cancer campaign (May-July 2012) in comparison to the same months in 2011 (an increase of around 700 cases; from 7,639 cases in May-July 2011 to 8,335 cases in May-July 2012) whilst there was no statistically significant change during the control period. Additionally, there was a statistically significant increase of 3.6 percentage points for the proportion of Non Small Cell Lung Cancers (including carcinoid tumours) diagnosed at an early stage (stage I and II) for patients first seen during the campaign months (May-July 2012) in comparison to the same months in 2011 (1,424/6,092 in May-July 2011 compared to 1,840/6,831 May-July 2012), and there was a corresponding statistically significant decrease in the proportion diagnosed at a late stage (stage IIIB and IV) (3,809/6,092 in May-July 2011 compared to 4,070/6,831 in May-July 2012), whilst there were no statistically significant changes in these proportions during the control period. Source: data extract from the National Lung Cancer Audit provided upon request from the Health and Social Care Information Centre (HSCIC).
*** Surveys conducted before and after the campaign show that when respondents were asked directly about whether or not certain key symptoms are warning signs of lung cancer, the proportion of people saying “cough lasting three weeks or more that doesn’t go away” was a definite warning sign rose significantly from 18% pre campaign to 33% post campaign.
****Using data from a sample of 486 GP practices, there was an increase of around 6 extra patient visits (of all ages) per practice per week, on average for the sample, during the 8 weeks of the campaign compared with the same 8 weeks in the previous year. For those aged 50 and over – the campaign’s target age group – this was equivalent to around 3 extra patient visits per practice per week.
University of Leicester