Lung cancer stage-shift following a symptom awareness campaign

Martyn P T Kennedy; Leanne Cheyne; Michael Darby; Paul Plant; Richard Milton; Jonathan M Robson; Alison Gill; Puneet Malhotra; Victoria Ashford-Turner; Kirsty Rodger; Elankumaran Paramasivam; Annette Johnstone; Bobby Bhartia; Shishir Karthik; Catherine Foster; Veronica Lovatt; Francesca Hewitt; Louise Cresswell; Victoria H Coupland; Margreet Lüchtenborg; Ruth H Jack; Henrik Moller; Matthew E J Callister

doi:10.1136/thoraxjnl-2018-211842

Lung cancer stage-shift following a symptom awareness campaign

Martyn P T Kennedy
, Leanne Cheyne
, Michael Darby
, Paul Plant
, Richard Milton
, Jonathan M Robson
, Alison Gill
, Puneet Malhotra
, Victoria Ashford-Turner
, Kirsty Rodger
, Elankumaran Paramasivam
, Annette Johnstone
, Bobby Bhartia
, Shishir Karthik
, Catherine Foster
, Veronica Lovatt
, Francesca Hewitt
, Louise Cresswell
, Victoria H Coupland
, Margreet Lüchtenborg

Ruth H Jack, Henrik Moller, Matthew E J Callister

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

87 Citationer (Scopus)

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 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.

Originalsprog	Engelsk
Tidsskrift	Thorax
Vol/bind	73
Udgave nummer	12
Sider (fra-til)	1128-1136
Antal sider	9
ISSN	0040-6376
DOI	https://doi.org/10.1136/thoraxjnl-2018-211842
Status	Udgivet - dec. 2018
Udgivet eksternt	Ja

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10.1136/thoraxjnl-2018-211842

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Citationsformater

Kennedy, M. P. T., Cheyne, L., Darby, M., Plant, P., Milton, R., Robson, J. M., Gill, A., Malhotra, P., Ashford-Turner, V., Rodger, K., Paramasivam, E., Johnstone, A., Bhartia, B., Karthik, S., Foster, C., Lovatt, V., Hewitt, F., Cresswell, L., Coupland, V. H., ... Callister, M. E. J. (2018). Lung cancer stage-shift following a symptom awareness campaign. Thorax, 73(12), 1128-1136. https://doi.org/10.1136/thoraxjnl-2018-211842

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title = "Lung cancer stage-shift following a symptom awareness campaign",

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 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.",

keywords = "Abdominal Neoplasms, Aged, Aged, 80 and over, Diagnostic Self Evaluation, Early Detection of Cancer/trends, Female, General Practice/education, Health Education, Health Knowledge, Attitudes, Practice, Humans, Lung Neoplasms/diagnostic imaging, Male, Middle Aged, Neoplasm Staging, Primary Health Care, Radiography, Thoracic/trends, Symptom Assessment, United Kingdom",

author = "Kennedy, \{Martyn P T\} and Leanne Cheyne and Michael Darby and Paul Plant and Richard Milton and Robson, \{Jonathan M\} and Alison Gill and Puneet Malhotra and Victoria Ashford-Turner and Kirsty Rodger and Elankumaran Paramasivam and Annette Johnstone and Bobby Bhartia and Shishir Karthik and Catherine Foster and Veronica Lovatt and Francesca Hewitt and Louise Cresswell and Coupland, \{Victoria H\} and Margreet L{\"u}chtenborg and Jack, \{Ruth H\} and Henrik Moller and Callister, \{Matthew E J\}",

note = "{\textcopyright} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",

year = "2018",

month = dec,

doi = "10.1136/thoraxjnl-2018-211842",

language = "English",

volume = "73",

pages = "1128--1136",

journal = "Thorax",

issn = "0040-6376",

publisher = "BMJ Publishing Group",

number = "12",

}

Kennedy, MPT, Cheyne, L, Darby, M, Plant, P, Milton, R, Robson, JM, Gill, A, Malhotra, P, Ashford-Turner, V, Rodger, K, Paramasivam, E, Johnstone, A, Bhartia, B, Karthik, S, Foster, C, Lovatt, V, Hewitt, F, Cresswell, L, Coupland, VH, Lüchtenborg, M, Jack, RH, Moller, H & Callister, MEJ 2018, 'Lung cancer stage-shift following a symptom awareness campaign', Thorax, bind 73, nr. 12, s. 1128-1136. https://doi.org/10.1136/thoraxjnl-2018-211842

TY - JOUR

T1 - Lung cancer stage-shift following a symptom awareness campaign

AU - Kennedy, Martyn P T

AU - Cheyne, Leanne

AU - Darby, Michael

AU - Plant, Paul

AU - Milton, Richard

AU - Robson, Jonathan M

AU - Gill, Alison

AU - Malhotra, Puneet

AU - Ashford-Turner, Victoria

AU - Rodger, Kirsty

AU - Paramasivam, Elankumaran

AU - Johnstone, Annette

AU - Bhartia, Bobby

AU - Karthik, Shishir

AU - Foster, Catherine

AU - Lovatt, Veronica

AU - Hewitt, Francesca

AU - Cresswell, Louise

AU - Coupland, Victoria H

AU - Lüchtenborg, Margreet

AU - Jack, Ruth H

AU - Moller, Henrik

AU - Callister, Matthew E J

PY - 2018/12

Y1 - 2018/12

N2 - 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.

AB - 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.

KW - Abdominal Neoplasms

KW - Aged

KW - Aged, 80 and over

KW - Diagnostic Self Evaluation

KW - Early Detection of Cancer/trends

KW - Female

KW - General Practice/education

KW - Health Education

KW - Health Knowledge, Attitudes, Practice

KW - Humans

KW - Lung Neoplasms/diagnostic imaging

KW - Male

KW - Middle Aged

KW - Neoplasm Staging

KW - Primary Health Care

KW - Radiography, Thoracic/trends

KW - Symptom Assessment

KW - United Kingdom

U2 - 10.1136/thoraxjnl-2018-211842

DO - 10.1136/thoraxjnl-2018-211842

M3 - Journal article

C2 - 29950525

SN - 0040-6376

VL - 73

SP - 1128

EP - 1136

JO - Thorax

JF - Thorax

IS - 12

ER -

Lung cancer stage-shift following a symptom awareness campaign

Abstract

Bibliografisk note

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AUB Link

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