Department of Psychology, School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK.
National Cancer Registration and Analysis Service, Public Health England, London, UK.
Eur J Cancer Care (Engl). 2022 May;31(3):e13583. doi: 10.1111/ecc.13583. Epub 2022 Apr 5.
More than a third of women diagnosed with breast cancer in England, and over half of those who die from it, are over 70. The Be Clear on Cancer Breast Cancer in Women over 70 Campaign, running three times, 2014-2018, aimed to promote early diagnosis of breast cancer in England by raising symptom awareness and encouraging women to see their general practitioner (GP) without delay. We sought to establish whether the third campaign had successfully met its aims.
Metrics covering the patient pathway, including symptom awareness, attending a GP practice with symptoms, urgent GP referral, diagnosis and stage of cancer, were assessed using national cancer databases and two household surveys.
The third campaign was associated with an increase in urgent cancer referrals, and therefore mammograms and ultrasounds performed. This was associated with an increase in breast cancers diagnosed. There was a delayed effect on GP attendances. Awareness of breast cancer prevalence for the 70-and-over age group improved. Impact on these metrics diminished across successive campaigns.
Future campaigns should focus on harder-to-reach women and include GPs as targets as this campaign showed a potential to affect referral behaviour.
在英格兰,超过三分之一被诊断患有乳腺癌的女性,以及超过一半死于乳腺癌的女性,年龄都在 70 岁以上。“明确癌症——70 岁以上女性乳腺癌”运动开展了三次,时间跨度为 2014 年至 2018 年,旨在通过提高对乳腺癌症状的认识并鼓励女性及时看全科医生(GP),从而促进英格兰 70 岁以上女性的早期诊断。我们试图确定第三次运动是否成功实现了其目标。
使用国家癌症数据库和两项家庭调查,评估了包括症状意识、出现症状时到 GP 诊所就诊、紧急 GP 转介、诊断和癌症分期在内的患者路径的指标。
第三次运动与紧急癌症转诊的增加相关,因此进行了更多的乳房 X 光检查和超声检查。这与诊断出的乳腺癌数量增加有关。对 GP 就诊的影响有延迟。70 岁及以上年龄组的乳腺癌患病率意识有所提高。这些指标的影响在连续的运动中逐渐减弱。
未来的运动应重点关注更难接触到的女性,并将全科医生作为目标人群,因为该运动表明有可能影响转诊行为。