title: Early diagnosis of lung cancer: evaluation of a community-based social marketing intervention.
abstract: BACKGROUND
  Poor U.K. lung cancer survival rates may, in part, be due to late diagnosis.
  
  
  OBJECTIVE
  To evaluate the effectiveness of a mixed-method community-based social marketing intervention on lung cancer diagnoses.
  
  
  METHODS
  A public awareness campaign in conjunction with brief intervention training in general practices was piloted in six localities with a high lung cancer incidence. End points were self-reported awareness of lung cancer symptoms; intention to seek healthcare; chest x-ray referral rates in primary care; secular trends in the incidence of lung cancer and stage at diagnosis, compared before and after the intervention.
  
  
  RESULTS
  21% (128/600) (95% CI 18% to 25%) of the targeted population recalled something about the campaign. Compared with a responder in the control area, the odds of a responder in the intervention area saying that they would visit their general practitioner and request a chest x-ray for a cough was 1.97 times (95% CI 1.18 to 3.31, p=0.01). Primary care chest x-ray referral rates increased by 20% in the targeted practices in the year following the intervention compared with a 2% fall in the control practices. The difference was highly significant, with an incidence rate ratio of 1.22 (95% CI 1.12 to 1.33, p=0.001). There was a 27% increase in lung cancer diagnoses in the intervention area compared with a fall in the control area. The incidence rate ratio was 1.42 (95% CI 0.83 to 2.44 p=0.199).
  
  
  CONCLUSIONS
  This is encouraging early evidence that an awareness and early recognition initiative may facilitate lung cancer diagnosis.
authors: Chest Clinic, South Block, Doncaster Royal Infirmary, Armthorpe Road, Doncaster DN2 5LT, UK. v.athey@sheffield.ac.uk
authors: Victoria L
authors: VL
authors: Athey
authors: Rupert J
authors: RJ
authors: Suckling
authors: Angela M
authors: AM
authors: Tod
authors: Stephen J
authors: SJ
authors: Walters
authors: Trevor K
authors: TK
authors: Rogers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008168:Lung / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008389:Marketing of Health Services / Q000379:methods; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D011859:Radiography; D040241:Social Marketing