Introduction Lung cancer prognosis depends on staging at time of diagnosis and delayed presentation contributes significantly to poor survival rates. The Doncaster public awareness cough campaign resulted in a significant increase in lung cancer diagnoses but not stage at presentation. The effect of early awareness campaigns on treatment rates has not previously been reported. Therefore we evaluated the impact on lung cancer diagnoses at our institution following a similar media based campaign piloted in the Midlands, with particular reference to lung cancer stage, patient fitness and treatment.
Method We conducted a case control cohort study comparing patients diagnosed at our institution in the 3 months following the campaign in 2011 to the same time period in 2010. Data on chest X-ray referrals were obtained from local imaging systems. Patient and lung cancer information were obtained from data submitted to the National Lung Cancer Audit. Statistical analyses were performed using SPSS.
Result are shown in Table 1. Following the campaign, GP chest X-ray referrals increased by 27%, whereas outpatient chest X-ray referrals remained unchanged. The number of lung cancers diagnosed increased by 24%. The proportion of patients with good performance status significantly improved, as did measured lung function. There was a 9% increase in early stage cancer although this did not reach statistical significance. However, the proportion of patients undergoing surgical resection significantly increased from 14% to 31%, p<0.05.
Conclusions The results suggest that the regional lung cancer public awareness campaign was successful in increasing GP and public awareness with a consequent increase in lung cancer diagnoses at our institution. Furthermore, patients appeared to present with better performance status and preserved lung function which may, together with the trend to earlier stage at diagnosis, explain the significant improvement in surgical resection rates. These results are very promising and wider evaluation of the regional campaign is awaited with interest.
References Athey V, Suckling RJ, Tod AM, Walters J & Rogers TK. Early diagnosis of lung cancer: evaluation of a community-based social marketing intervention. Thorax May 2012; 67(5): 412–417.