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Knowledge of lung cancer symptoms and risk factors in the UK: development of a measure and results from a population-based survey
  1. Alice E Simon1,
  2. Dorota Juszczyk1,
  3. Nina Smyth1,
  4. Emily Power1,
  5. Sara Hiom2,
  6. Michael D Peake3,
  7. Jane Wardle1
  1. 1Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, London, UK
  2. 2Director of Information, Cancer Research UK, London, UK
  3. 3Department of Respiratory Medicine, University Hospitals of Leicester, Glenfield Hospital, Leicester, UK
  1. Correspondence to Dr Alice E Simon, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, 1-19 Torrington Place, London WC1E 6BT, UK; alice.simon{at}


Objectives To develop and validate a Lung Cancer Awareness Measure (Lung CAM) and explore the demographical and social predictors of lung cancer awareness in the general population.

Methods study 1 Symptoms and risk factors for lung cancer were identified from the medical literature and health professional expertise in an iterative process. Test–retest reliability, internal reliability, item analyses, construct validity and sensitivity to changes in awareness of the Lung CAM were assessed in three samples (total N=191).

Results study 1 The Lung CAM demonstrated good internal (Cronbach's α=0.88) and test–retest reliability (r=0.81, p<0.001). Validity was supported by lung cancer experts scoring higher than equally educated controls (t(106)=8.7, p<0.001), and volunteers randomised to read lung cancer information scoring higher than those reading a control leaflet (t(81)=3.66, p<0.001).

Methods study 2 A population-based sample of 1484 adults completed the Lung CAM in a face-to-face, computer-assisted interview.

Results study 2 Symptom awareness was low (average recall of one symptom) and there was little awareness of risk factors other than smoking. Familiarity with cancer, and being from a higher socioeconomic group, were associated with greater awareness.

Conclusions Using a valid and reliable tool for assessing awareness showed the UK population to have low awareness of lung cancer symptoms and risk factors. Interventions to increase lung cancer awareness are needed to improve early detection behaviour.

  • Lung cancer
  • prevention and control
  • awareness
  • questionnaire design
  • health survey
  • exercise
  • psychology
  • tobacco and the lung
  • clinical epidemiology
  • lung cancer chemotherapy
  • mesothelioma
  • non-small cell lung cancer
  • small cell lung cancer

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  • Funding This research was funded by Cancer Research UK.

  • Competing interests None.

  • Ethics approval The development studies and population survey come under one of the 'exemption' clauses of the ethics board and these studies did not require formal approval. We have email correspondence with the ethics board administrator confirming this.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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