Evaluation of a national lung cancer symptom awareness campaign in Wales

Abstract Background Lung cancer is the leading cause of cancer mortality in Wales. We conducted a before- and after- study to evaluate the impact of a four-week mass-media campaign on awareness, presentation behaviour and lung cancer outcomes. Methods Population-representative samples were surveyed for cough symptom recall/recognition and worry about wasting doctors’ time pre-campaign (June 2016; n = 1001) and post-campaign (September 2016; n = 1013). GP cough symptom visits, urgent suspected cancer (USC) referrals, GP-ordered radiology, new lung cancer diagnoses and stage at diagnosis were compared using routine data during the campaign (July–August 2016) and corresponding control (July–August 2015) periods. Results Increased cough symptom recall ( p < 0.001), recognition ( p < 0.001) and decreased worry ( p < 0.001) were observed. GP visits for cough increased by 29% in the target 50+ age-group during the campaign ( p < 0.001) and GP-ordered chest X-rays increased by 23% ( p < 0.001). There was no statistically significant change in USC referrals ( p = 0.82), new ( p = 0.70) or early stage ( p = 0.27) diagnoses, or in routes to diagnosis. Conclusions Symptom awareness, presentation and GP-ordered chest X-rays increased during the campaign but did not translate into increased USC referrals or clinical outcomes changes. Short campaign duration and follow-up, and the small number of new lung cancer cases observed may have hampered detection effects.