Lung cancer stage-shift following a symptom awareness campaign. Issue 12 (27th June 2018)

• Record Type: Journal Article
• Authors: Kennedy, Martyn P T; Cheyne, Leanne; Darby, Michael; Plant, Paul; Milton, Richard; Robson, Jonathan M; 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; Moller, Henrik; Callister, Matthew E J
• Is Part Of: Thorax. Volume 73:Issue 12(2018)
• Page Start: 1128
• Page End: 1136
• Publication Date: 2018-06-27
• Subjects: lung cancer; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thoraxjnl-2018-211842
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : 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 χ 2 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 (χ 2 (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.