Lung cancer stage-shift following a symptom awareness campaign
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 p...
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| Format: | Article |
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BMJ Publishing Group
2018
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| Online Access: | https://eprints.nottingham.ac.uk/53147/ |
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| author | Kennedy, Martyn Cheyne, Leanne Darby, Michael Plant, Paul Milton, Richard Robson, Jonathan Gill, Alison Malhotra, Puneet Ashford-Turner, Victoria Rodger, Kirsty Paramasivam, Elankumaran Johnstone, Annette Bhartia, Bobby Karthik, Shishir Foster, Catherine Lovatt, Veronica Hewitt, Francesca Cresswell, Louise Coupland, Victoria H. Lüchtenborg, Margreet Jack, Ruth H. Møller, Henrik Callister, Matthew E. |
| author_facet | Kennedy, Martyn Cheyne, Leanne Darby, Michael Plant, Paul Milton, Richard Robson, Jonathan Gill, Alison Malhotra, Puneet Ashford-Turner, Victoria Rodger, Kirsty Paramasivam, Elankumaran Johnstone, Annette Bhartia, Bobby Karthik, Shishir Foster, Catherine Lovatt, Veronica Hewitt, Francesca Cresswell, Louise Coupland, Victoria H. Lüchtenborg, Margreet Jack, Ruth H. Møller, Henrik Callister, Matthew E. |
| author_sort | Kennedy, Martyn |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T20:26:55Z |
| format | Article |
| id | nottingham-53147 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:26:55Z |
| publishDate | 2018 |
| publisher | BMJ Publishing Group |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-531472024-08-15T15:30:13Z https://eprints.nottingham.ac.uk/53147/ Lung cancer stage-shift following a symptom awareness campaign Kennedy, Martyn Cheyne, Leanne Darby, Michael Plant, Paul Milton, Richard Robson, Jonathan Gill, Alison Malhotra, Puneet Ashford-Turner, Victoria Rodger, Kirsty Paramasivam, Elankumaran Johnstone, Annette Bhartia, Bobby Karthik, Shishir Foster, Catherine Lovatt, Veronica Hewitt, Francesca Cresswell, Louise Coupland, Victoria H. Lüchtenborg, Margreet Jack, Ruth H. Møller, Henrik Callister, Matthew E. 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. BMJ Publishing Group 2018-06-27 Article PeerReviewed Kennedy, Martyn, Cheyne, Leanne, Darby, Michael, Plant, Paul, Milton, Richard, Robson, Jonathan, Gill, Alison, Malhotra, Puneet, Ashford-Turner, Victoria, Rodger, Kirsty, Paramasivam, Elankumaran, Johnstone, Annette, Bhartia, Bobby, Karthik, Shishir, Foster, Catherine, Lovatt, Veronica, Hewitt, Francesca, Cresswell, Louise, Coupland, Victoria H., Lüchtenborg, Margreet, Jack, Ruth H., Møller, Henrik and Callister, Matthew E. (2018) Lung cancer stage-shift following a symptom awareness campaign. Thorax . ISSN 1468-3296 Lung Cancer; Symptom Awareness https://thorax.bmj.com/content/early/2018/06/27/thoraxjnl-2018-211842 doi: 10.1136/thoraxjnl-2018-211842 doi: 10.1136/thoraxjnl-2018-211842 |
| spellingShingle | Lung Cancer; Symptom Awareness Kennedy, Martyn Cheyne, Leanne Darby, Michael Plant, Paul Milton, Richard Robson, Jonathan Gill, Alison Malhotra, Puneet Ashford-Turner, Victoria Rodger, Kirsty Paramasivam, Elankumaran Johnstone, Annette Bhartia, Bobby Karthik, Shishir Foster, Catherine Lovatt, Veronica Hewitt, Francesca Cresswell, Louise Coupland, Victoria H. Lüchtenborg, Margreet Jack, Ruth H. Møller, Henrik Callister, Matthew E. Lung cancer stage-shift following a symptom awareness campaign |
| title | Lung cancer stage-shift following a symptom awareness campaign |
| title_full | Lung cancer stage-shift following a symptom awareness campaign |
| title_fullStr | Lung cancer stage-shift following a symptom awareness campaign |
| title_full_unstemmed | Lung cancer stage-shift following a symptom awareness campaign |
| title_short | Lung cancer stage-shift following a symptom awareness campaign |
| title_sort | lung cancer stage-shift following a symptom awareness campaign |
| topic | Lung Cancer; Symptom Awareness |
| url | https://eprints.nottingham.ac.uk/53147/ https://eprints.nottingham.ac.uk/53147/ https://eprints.nottingham.ac.uk/53147/ |