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‘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But further data from Cancer Research UK, based on unpublished interim findings from an analysis of data at 486 GP practices and shown to Pulse, reveal that attendances for persistent cough among patients aged 50 or over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.’