This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

'Three week cough' lung cancer campaign prompted at least 200,000 additional GP attendances, new figures suggest

Exclusive A controversial lung cancer awareness campaign that achieved an extra 700 lung cancer diagnoses may also have resulted in at least 200,000 additional GP attendances, new figures obtained by Pulse suggest.

Cancer Research UK announced yesterday that the Government-led “Be Clear on Cancer” campaign, which ran throughout England in May and June 2012 and urged patients who had had a cough for more than three weeks to visit their GP, led to around 700 extra patients being diagnosed with lung cancer. Its analysis, based on a data extract from the National Lung Cancer Audit and compared with the same period in 2011, also found 400 of those patients had their cancer picked up at an early stage.

But further data from Cancer Research UK, based on unpublished interim findings from an analysis of data at 486 GP practices and shown to Pulse, reveal that attendances for persistent cough among patients aged 50 or over increased by 62% during the campaign, compared with the same period in the previous year. Adjusted for bank holidays, Cancer Research UK said that equated to 3.17 additional visits per practice per week.

Attendances in patients aged 50 or over for a series of control symptoms – UTI, knee pain, shoulder pain and neck pain – showed a maximum increase in activity of 4% during the campaign compared with the same period in 2011.

Extrapolated across approximately 8,100 GP practices in England in the eight and half weeks the campaign ran, and allowing for the small rise in overall activity measured in the control symptoms, the figures suggest there were approximately 200,000 additional GP attendances for persistent cough during the campaign.

Cancer Research UK said that its calculations using figures from the National Cancer Intelligence Network, which cover 7,965 practices and use weekly average figures rather than figures per practice, found that the figure was around 236,000.

In addition, Cancer Research UK said the same analysis of 486 GP practices also showed that attendances among patients aged 50 or over were up 55% in the eight weeks following the campaign, compared with the same period the previous year.

The ‘Be Clear on Cancer’ campaign was launched in May 2012 after regional pilots, with TV, radio, print and online adverts urging patients to consult their GP if they had had a persistent cough lasting more than three weeks.

At the time, the broad message of the campaign - which did not stress risk factors such as age or smoking history - led to concerns that it could result in an influx of ‘the worried-well’.

The Department of Health and Public Health England have hailed the ‘Be Clear on Cancer’ initiative – which also includes separate campaigns tackling bowel, breast, bladder, kidney, oesophago-gastric and ovarian cancers – as a success, and Public Health England has renewed the scheme in 2013-14.

But in response to the figures showing the estimated number of additional GP consultations, GP leaders warned that the profession’s capacity to absorb additional attendances is ‘not unlimited’ and urged public health chiefs to plan for the impact on GP services.

Professor Greg Rubin, RCGP and Cancer Research UK clinical lead on cancer, said: ‘What the evaluation of the ”Be Clear on Cancer” [campaign] has found is not only did they have 700 more cancer diagnoses, but there was a stage shift. In other words, they identified people at an earlier stage of cancer. So these people were treatable. And that’s the good thing.’

‘But certainly there was, I think, a 30% increase in two-week wait referrals during that period. And there was an increase in the number of GP consultations during that period. And if you have campaigns of this sort, the capacity of a service to absorb the extra activity isn’t unlimited.’

‘That’s not to say the campaigns are a bad thing, but we should plan for their impact on services.’

GPC chair Dr Chaand Nagpaul added: ‘It’s clearly important to detect, diagnose and treat cancer as early as possible. That’s clearly a positive thing. However we do need to bear in mind that if this “Be Clear on Cancer” campaign has resulted in greater numbers of patients visiting their GP practice, then clearly there are going to be trade-offs.’

‘General practice is already saturated. GPs are very prepared to play their full part in all health priorities – such as seeing patients to detect early cancer. But what’s important is to recognise that general practice doesn’t have unlimited elasticity, and if we are to see more patients then we do need more GPs and more appointments.’

Readers' comments (15)

  • As long as the coughing has stopped............

    Unsuitable or offensive? Report this comment

  • Argil

    It is interesting indeed that it is believed that the "Be Clear on Cancer” [campaign] has found is not only did they have 700 more cancer diagnoses, but there was a stage shift. However, I would be very keen to know more on this. For instance, I believe the study compared the number of diagnoses made during the campaign months against the year before. I would be keen to know what did happen over the same period of time over the last 5 years. It is possible that numbers have been "swinging". Surely it is of some concern the significant increase in waiting list, and the extra-work as there are many other serious illnesses needing prompt attention.
    I would have hoped for a more targeted campaign (smoker, perhaps over 40...).

    Unsuitable or offensive? Report this comment

  • "general practice doesn’t have unlimited elasticity"

    Never a truer word spoken.

    Unsuitable or offensive? Report this comment

  • I did not notice a particular increase over lung cancer fears - but saw numerous teenagers and those in their early 20's with minor rectal bleeding worried they had bowel cancer when that advert went out - all demanding same day appointments.

    Unsuitable or offensive? Report this comment

  • I am all for improving early detection and more than happy to see them as long as its funded appropriately. If we changed to a item based payment we will not have any problems if anyone wants GP`s to see more patients. The capitation system was for average 2 -3 visits per year. we are between 7-10 consultations per patient per year.

    The present blooper is blood in urine -"Even if its once". I have had 20 ladies in their 20s and 30 s asking if ther recurrent cystitis was a sign of cancer. If targetted at men aged over 60 it may be be more relevant.
    The present system is unsustainable.

    Unsuitable or offensive? Report this comment

  • How many of the 199,300 who had unnecessary chest xrays risk cancer from radiation as with mammography.

    Unsuitable or offensive? Report this comment

  • Fantastic news that this identified new cancers at a potentially treatable stage of illness. Sorry that it dented practice income and meant more work for GPs.

    Unsuitable or offensive? Report this comment

  • This is a very superficial headline grabbing analysis. If public health England is so sure about the value of doing CXRs on all persistent coughers, then why not make a scientific case for a national screening campaign whcih would need to be properly resourced and evaluated.

    As we all know the value of breast screening is at best doubtful, and as for PSA testing, I believe this has been thorughly discredited as a screening tool both in the US and the UK. That does not prevent sound bite hungry politicians such as Boris promoting it.

    Unsuitable or offensive? Report this comment

  • " Sorry that it dented practice income and meant more work for GPs."

    Oh dear. We have another 'contributor' with simple thinking here.

    It hasn't dented practice income in the slightest - it's been neutral.

    It's a shame you don't realise that the squeeze on time and appointments that this has caused has probably delayed the diagnosis of other, potentially treatable cancers. Still, let's go back to measuring what's easy to measure, right?

    Unsuitable or offensive? Report this comment

  • @1047, next time you have a moan about not being able to get an appointment at the GP surgery, think of your comment here.

    I think it is fine that practices take on this extra work, but practices will only provide extra service if the work is funded. Otherwise you will just be shifting resource from one service to another.

    It is not appropriate for the service that shouts the loudest and appeals to politicians to take resources away from the less cool services like mental health problems and services for vulnerable adults. In this case however, I think Ca lung probably gets less than it's fair share of resources overall.

    I also think it is appropriate to think about how the campaign can be improved by gaining the same outcome with less resources. How on earth did they come up with 3 weeks? I send my patients for x-ray at 6 weeks productive cough - am I just doing it wrong? Do we really have to say half the time so those that choose their legal right to manage their own health are duped into following the rules by over hyping the time frame?

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page

Have your say