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

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.