How can a marketing campaign improve lung cancer survival?

You may have seen in today’s news that a lung cancer awareness campaign has had a striking impact on earlier lung cancer detection.

Here, Amanda Boughey, Programme Lead for Be Clear on Cancer at Cancer Research UK, gives her take on this momentous day.

Can a marketing campaign really be effective in boosting lung cancer survival? Three years ago, I wouldn’t have been able to answer that question. But today we are much closer thanks to the Be Clear on Cancer campaign for lung cancer.

In autumn 2010, I met a group of lung specialists who were passionate about changing the prognosis for lung cancer in England. They kept saying that one of their main problems is that lung cancer patients reach them too late, so potentially curative surgery isn’t an option. This was backed up by the statistics.

Lung cancer is England’s biggest cancer killer taking the lives of around 28,000 people every year. When diagnosed at its earliest stage, around 73 per cent of patients with the most common kind of lung cancer – called non small cell lung cancer (NSCLC) – and around 56 per cent of patients with small cell lung cancer (SCLC) will survive their disease for at least one year after diagnosis. But therein lies the problem, only 10-15 per cent of lung cancer patients in England are diagnosed at the earliest stage, compared to around 70 per cent diagnosed at a late stage.

We knew from social marketing campaigns in several places round England, such as the ‘cough cough’ campaign in Doncaster, that there was definitely more work to be done on raising awareness of lung cancer symptoms. But, was it foolish to think that we could achieve something more than just awareness through a marketing campaign?

Heated debate

“Is it ethically responsible to run this campaign – will you just be issuing the terminal news a little earlier?”

We all knew it wouldn’t be easy and a meeting later that year reminded me just how challenging it was going to be. I sat in a room with representatives from the cancer networks and primary care talking to them about the Be Clear on Cancer lung campaign that would be running in their areas.

The debate became heated when the challenges grew vigorous. “How do you know this campaign will work?” I was asked. “Can you guarantee that my surgery won’t be swamped with people who are in a panic after seeing the campaign?” “What evidence do you have that this will show a shift in stage?” and most thought-provoking of all: “Is it ethically responsible to run this campaign – will you just be issuing the terminal news a little earlier?”

We didn’t have lots of evidence and we didn’t know how many people would walk through their GP’s surgery doors. It would be difficult until we got some of the answers and built the evidence base. So we needed to run some pilots.

Gathering the evidence

Local projects dotted around England appeared to work, but we needed a bigger regional campaign to understand fully the impact on the NHS. We started in the Midlands area with a TV advertisement showing a man and woman coughing and then talking to their GP. We came in for some criticism about whether this was an appropriate use of NHS money, whether GPs would be inundated because a 3-week cough was so common, and patient groups argued that we should have included other symptoms, or made it clear that lung cancer also affects non-smokers.

Despite the challenges, colleagues at Public Health England and Department of Health, with support from Cancer Research UK, pushed on and rolled the Be Clear on Cancer lung cancer campaign out nationally in 2012.

We kept calm and carried on.

A story of success

Thankfully, good news started to emerge in December 2012 when some early data on the regional lung cancer pilot indicated that more cancers had been diagnosed and at an earlier stage. But numbers were relatively small and we still needed more information to answer all those challenging questions.

Today, the newspapers are covering the story of our success. Around 700 additional cancers diagnosed, 400 cases at an earlier stage – you can read the press release for all the details.

But for me, the real reason that today is momentous goes back to that question that had niggled away at me for three years –“Is it ethically responsible to run this campaign? Will you just be issuing the terminal news a little earlier?” It can now be firmly put to bed. Yes it is responsible because today 300 people, many of whom are mums, dads, and grandparents, have had potentially lifesaving surgery.

We are changing the prognosis for lung cancer in England. It will take great efforts to keep us moving in the right direction, more research into lung cancer, greater access to diagnostic tests and better treatments.

I am proud to say a social marketing campaign can make a difference. But this is only the start. We must continue to keep early diagnosis as a priority for local NHS teams, government bodies and charities if we are to continue to improve the outcomes for lung cancer patients.

Amanda