title: An evaluation of the impact of large-scale interventions to raise public awareness of a lung cancer symptom.
abstract: BACKGROUND
  Long-term lung cancer survival in England has improved little in recent years and is worse than many countries. The Department of Health funded a campaign to raise public awareness of persistent cough as a lung cancer symptom and encourage people with the symptom to visit their GP. This was piloted regionally within England before a nationwide rollout.
  
  
  METHODS
  To evaluate the campaign's impact, data were analysed for various metrics covering public awareness of symptoms and process measures, through to diagnosis, staging, treatment and 1-year survival (available for regional pilot only).
  
  
  RESULTS
  Compared with the same time in the previous year, there were significant increases in metrics including: public awareness of persistent cough as a lung cancer symptom; urgent GP referrals for suspected lung cancer; and lung cancers diagnosed. Most encouragingly, there was a 3.1 percentage point increase (P<0.001) in proportion of non-small cell lung cancer diagnosed at stage I and a 2.3 percentage point increase (P<0.001) in resections for patients seen during the national campaign, with no evidence these proportions changed during the control period (P=0.404, 0.425).
  
  
  CONCLUSIONS
  To our knowledge, the data are the first to suggest a shift in stage distribution following an awareness campaign for lung cancer. It is possible a sustained increase in resections may lead to improved long-term survival.
authors.affiliation: Statistical Information Team, Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD, UK.
authors.forename: L
authors.initials: L
authors.lastname: Ironmonger
authors.affiliation: Statistical Information Team, Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD, UK.
authors.forename: E
authors.initials: E
authors.lastname: Ohuma
authors.affiliation: Statistical Information Team, Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD, UK.
authors.forename: N
authors.initials: N
authors.lastname: Ormiston-Smith
authors.affiliation: Knowledge and Intelligence Team (East Midlands), Public Health England, Sheffield S10 3TG, UK.
authors.forename: C
authors.initials: C
authors.lastname: Gildea
authors.affiliation: 1] Statistical Information Team, Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD, UK [2] Information Services Division, NHS National Services Scotland, Edinburgh EH12 9EB, UK.
authors.forename: C S
authors.initials: CS
authors.lastname: Thomson
authors.affiliation: 1] Department of Respiratory Medicine, Glenfield Hospital, Leicester LE3 9QP, UK [2] National Cancer Intelligence Network, Public Health England, Wellington House, London SE1 8UG, UK [3] Royal College of Physicians, London NW1 4LE, UK.
authors.forename: M D
authors.initials: MD
authors.lastname: Peake
mesh_terms: D003371:Cough / Q000209:etiology*; D004739:England; D005260:Female; D058006:General Practice; D058005:General Practitioners; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D015397:Program Evaluation; D011634:Public Health / Q000379:methods; D017741:Survivors; D013690:Television