RT Journal Article SR Electronic T1 Lung cancer stage-shift following a symptom awareness campaign JF Thorax JO Thorax FD BMJ Publishing Group Ltd and British Thoracic Society SP 1128 OP 1136 DO 10.1136/thoraxjnl-2018-211842 VO 73 IS 12 A1 Martyn P T Kennedy A1 Leanne Cheyne A1 Michael Darby A1 Paul Plant A1 Richard Milton A1 Jonathan M Robson A1 Alison Gill A1 Puneet Malhotra A1 Victoria Ashford-Turner A1 Kirsty Rodger A1 Elankumaran Paramasivam A1 Annette Johnstone A1 Bobby Bhartia A1 Shishir Karthik A1 Catherine Foster A1 Veronica Lovatt A1 Francesca Hewitt A1 Louise Cresswell A1 Victoria H Coupland A1 Margreet Lüchtenborg A1 Ruth H Jack A1 Henrik Moller A1 Matthew E J Callister YR 2018 UL http://thorax.bmj.com/content/73/12/1128.abstract AB Background Lung cancer outcomes in the UK are worse than in many other developed nations. Symptom awareness campaigns aim to diagnose patients at an earlier stage to improve cancer outcomes.Methods An early diagnosis campaign for lung cancer commenced in Leeds, UK in 2011 comprising public and primary-care facing components. Rates of community referral for chest X-ray and lung cancer stage (TNM seventh edition) at presentation were collected from 2008 to 2015. Linear trends were assessed by χ2 test for trend in proportions. Headline figures are presented for the 3 years pre-campaign (2008–2010) and the three most recent years for which data are available during the campaign (2013–2015).Findings Community-ordered chest X-ray rates per year increased from 18 909 in 2008–2010 to 34 194 in 2013–2015 (80.8% increase). A significant stage shift towards earlier stage lung cancer was seen (χ2(1)=32.2, p<0.0001). There was an 8.8 percentage point increase in the proportion of patients diagnosed with stage I/II lung cancer (26.5% pre-campaign vs 35.3% during campaign) and a 9.3% reduction in the absolute number of patients diagnosed with stage III/IV disease (1254 pre-campaign vs 1137 during campaign).Interpretation This is the largest described lung cancer stage-shift in association with a symptom awareness campaign. A causal link between the campaign and stage-shift cannot be proven but appears plausible. Limitations of the analysis include a lack of contemporary control population.