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GPs must get behind the Be Clear on Cancer campaign and raise diagnosis rates

GPs shouldn’t be worried about an increase in patients as a result of the most recent ‘Be Clear on Cancer’ campaign, says cancer tsar Dr Sean Duffy, but should welcome the opportunity to alert patients who might be in danger, and increase earlier diagnosis of bladder and kidney cancers.

The next phase of the Be Clear on Cancer campaign launched this week, with the aim of increasing earlier diagnosis of bladder and kidney cancers. The campaign urges people to visit their GP if they notice blood in their pee, even if it’s ‘just the once’.

The context for this campaign is the Government’s commitment to improving cancer survival rates in England – it’s estimated that around 1,000 deaths from bladder and kidney cancer could be avoided each year if survival rates matched the best in Europe. Symptom awareness and earlier diagnosis lie at the heart of this and hold the key to saving lives.

Every year, around 16,600 people in England are diagnosed with bladder or kidney cancer[1] with approximately 7,500 people dying from the diseases.[2]  The campaign targets men and women over the age of 50 as these cancers are much more common in older age, with around 95% of cases diagnosed in those aged 50 and over.[3]

The reason for focusing on the symptom of ‘blood in pee’ is its association with both bladder and kidney cancers: it is a key symptom in over 80% of bladder cancers[4] and over half of kidney cancers.[5] However, one of the challenges we face in improving early diagnosis rates of both diseases is the relative lack of symptom awareness - when asked to name cancer signs and symptoms, only a third of people mention unexplained bleeding.[6]

We believe this campaign will be effective in raising awareness of blood in pee as a symptom of cancer and expect that more people will visit their doctor as a result. The campaign messages make clear that blood in pee probably isn’t anything serious, but that it needs to be checked out. GPs shouldn’t be worried about a sudden influx of patients – the Be Clear on Cancer national bowel cancer campaign in early 2012 only led to approximately one additional patient with relevant symptoms per practice every two weeks.  However, GPs do need to be aware of the campaign and refer patients on to secondary care as appropriate.

The forthcoming national campaign follows successful local and regional Be Clear on Cancer ‘Blood in Pee’ pilots. The regional pilot ran between January and March this year in the North East and Borders TV regions, and showed a 28% increase in two week-wait (2WW) referrals for suspected urological cancer.

And results from three local pilots in 2012 showed a 5.3% increase in the number of bladder or kidney cancers diagnosed following a 2WW urgent referral for suspected urological cancer.

We want this campaign to follow in the footsteps of previous successful Be Clear on Cancer campaigns, with your help. Please access the wealth of information available to support you and your practice. Working together we can make a real impact on improving survival rates for bladder and kidney cancers.

Visit for more information and resources

Dr Sean Duffy is National Clinical Director for Cancer Services at NHS England. He is also a clinical academic gynaecologist based at the University of Leeds, with a clinical practice at St James’s Hospital in Leeds.

[1] Data provided by the Office for National Statistics: on request, June 2012. Similar data can be found here:

[2] Office for National Statistics: Mortality Statistics: Deaths registered in 2010. England and Wales 2010. National Statistics: London

[3] Data provided by the Office for National Statistics: on request, June 2012. Similar data can be found here:

[4] Source: Wallace, DM, et al. Delay and survival in bladder cancer. BJU Int. 2002 Jun;89(9): p868-78

[5] Source: Tobias J & Hochhauser, D. Cancer and its management (6th edition). 2010: Blackwell publishing

[6] Unpublished data from the Cancer Awareness Measure conducted in 2012.

Readers' comments (4)

  • "GPs shouldn’t be worried about an increase in patients as a result of the most recent ‘Be Clear on Cancer’ campaign" - How would someone who isnt a GP know this?????

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  • thank you for coming on Pulse to explain the campaign Dr Duffy, we fully support this. It will lead to increased referral but I think great, if it means that we improve through earlier diagnosis then great. I am proud to be part of that strategy.

    - anonymous salaried!

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  • Kathrine Thomson

    Obviously this is an excellent campaign but the marketing information is dull, dull, dull. Web pages of [excellent] information, that Practice staff don’t have time to read and a leaflet [in English only] is not enough. The materials only cater to patients who visit the surgery and posters & leaflets are not effective. Set up links and tools for Practices – a video to show in the waiting room, an app for people to use on Facebook, a cartoon to show what symptoms people should look for, a fun quiz etc. etc. We have amazing opportunities to reach patients in the community nowadays and we are doing very little to exploit it.

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  • I do not think there is a single GP who is not in support of the initiative , but many like I want assuance of a joined up service co-ordination.

    This improved detection brings next years patient presentation into this years financial budget -which NHS England is so assiduosly performance managing practices on.What easement for this forseeable surge is made?

    Many clinicians note the small but real "extensive negative investigation" group that appear highly suggestable to these campaigns.
    How does our Tsar recommend we adress this area?
    What advance notice is given to our hospital colleagues of the phasing of these campaigns for organsation of consultant leave so the capacioty to meet the throughput is present at and shortly after the campaigns so we do not end up with worried 2 week wait patients on day 15 and punative financial sanction on the hositals for waiting time breaches?

    Sorry to be "joined up system thinking" , but obviously DOH is so many years ahead of me in comissioning experience that someone can answer these querys?...................

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