Rationale Lung cancer survival in North East London is consistently lower than expected. The incidence of late presentation with advanced, inoperable disease is significantly higher; our patients are also more likely to present via the emergency room than any other route.
In the absence of an evidence based national screening programme for lung cancer in the UK, a National Lung Cancer Awareness Campaign was launched in 2012 for eight weeks with TV, radio and poster advertising. The campaign urged anyone who had been suffering with a cough for three weeks or more to see their general practitioner and ask for a chest X Ray.
This study was designed to look at the impact of the national campaign on the local population in North East London.
Method Every patient diagnosed with lung cancer in the 124 days leading up to the start of the campaign was compared with every patient diagnosed for 124 days from the start of the campaign.
Results There was an 8% increase in the number of lung cancers diagnosed after the awareness campaign. The biggest increase was in squamous cell carcinoma.
Overall, there was no stage shift seen. However the Trust serves two sites each with a specific catchment area. Patients on one site showed a significant stage shift. Stage 1a to 2b, 10.8% pre-campaign, 25% post-campaign (p < 0.006)
On the site where the significant stage shift was seen the rate of eligibility for radical therapy rose threefold from 10.5% to 33.3% (P < 0.001). On both sites the rate of treatment with curative intent rose by 3.8% (NS).
Conclusion The national awareness campaign has had a measurable effect on our lung cancer service. Overall we have seen an 8% increase in cancers diagnosed, but the key finding is that the patients from one site had a significant increase in early stage diagnosis and a threefold increase in eligibility for radical therapy. This is the first real evidence that a national campaign might have a measurable effect on lung cancer mortality.