An evaluation of the impact of large-scale interventions to raise public awareness of a lung cancer symptom

TLDR

Long‑term lung cancer survival in England has improved little in recent years and remains worse than many other countries, though a sustained increase in resections could improve long‑term survival. The study aimed to evaluate the impact of a Department of Health‑funded public awareness campaign on lung cancer detection and outcomes across England. The campaign promoted persistent cough awareness and encouraged GP visits, and the authors analysed metrics of public awareness, urgent referrals, diagnosis, staging, treatment, and 1‑year survival to assess its effect. The campaign was associated with a 3.1‑percentage‑point rise in stage I non‑small cell lung cancer diagnoses and a 2.3‑percentage‑point increase in resections, with no changes during the control period, suggesting a shift in stage distribution.

Abstract

Long-term lung cancer survival in England has improved little in recent years and is worse than many countries. The Department of Health funded a campaign to raise public awareness of persistent cough as a lung cancer symptom and encourage people with the symptom to visit their GP. This was piloted regionally within England before a nationwide rollout.To evaluate the campaign's impact, data were analysed for various metrics covering public awareness of symptoms and process measures, through to diagnosis, staging, treatment and 1-year survival (available for regional pilot only).Compared with the same time in the previous year, there were significant increases in metrics including: public awareness of persistent cough as a lung cancer symptom; urgent GP referrals for suspected lung cancer; and lung cancers diagnosed. Most encouragingly, there was a 3.1 percentage point increase (P<0.001) in proportion of non-small cell lung cancer diagnosed at stage I and a 2.3 percentage point increase (P<0.001) in resections for patients seen during the national campaign, with no evidence these proportions changed during the control period (P=0.404, 0.425).To our knowledge, the data are the first to suggest a shift in stage distribution following an awareness campaign for lung cancer. It is possible a sustained increase in resections may lead to improved long-term survival.