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N. Scott



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    O29 - Cancer Control & Epidemiology IV (ID 132)

    • Event: WCLC 2013
    • Type: Oral Abstract Session
    • Track: Prevention & Epidemiology
    • Presentations: 1
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      O29.01 - Awareness about the signs and symptoms of lung cancer in Australia, a mixed methods study (ID 2583)

      10:30 - 12:00  |  Author(s): N. Scott

      • Abstract
      • Presentation
      • Slides

      Background
      The risk of developing lung cancer increases with age and is highly associated with exposure to tobacco smoking. This study aimed to understand public awareness about the risk of developing lung cancer in New South Wales (NSW), Australia and to investigate attitudes and beliefs about lung cancer which could potentially impact health seeking behaviours regarding symptoms of lung cancer. The risk of developing lung cancer increases with age and is highly associated with exposure to tobacco smoking. This study aimed to understand public awareness about the risk of developing lung cancer in New South Wales (NSW), Australia and to investigate attitudes and beliefs about lung cancer which could potentially impact health seeking behaviours regarding symptoms of lung cancer.

      Methods
      A mixed methods triangulation approach was used, with a sequential-parallel design which incorporated 16 qualitative focus groups (n=125) to explore themes. Participants were aged 45+ from metropolitan and regional centres and grouped according to smoking status (current, former and never smokers). Data were analysed by content and thematically. A cross sectional quantitative telephone survey (n=1,000) followed to determine overall awareness and generalisability of findings amongst adults >45 years across NSW.

      Results
      The qualitative research highlighted that symptoms of haemoptysis, dyspnoea and an unusual or persistent cough were well recognised symptoms of lung cancer however participants were more likely to assume these symptoms were related to other health problems. Haemoptysis was the only symptom which created a sense of urgency to seek immediate medical attention. A ‘wait and see’ attitude towards any concerning symptom was prevalent across groups, only severe/ long term persistent symptoms would induce action. Smokers and former heavy smokers were more likely to say they would delay seeing their doctor because of perceived stigma associated with smoking. Older participants were more likely to rely on previous experiences of symptoms to govern their health seeking behaviour. Perceived susceptibility and understanding of causes of lung cancer differed by smoking status; smokers more likely to down-play the risk of smoking or attempt to offset their risk through lifestyle choices. Former smokers were more likely to perceive their risk comparative with a never smoker. The quantitative research findings suggested that unprompted awareness of lung cancer related symptoms was high with 88.5% able to correctly identify ≥1 symptoms however symptoms were more typical of late stage cancer. Age(<65 years), sex(female) and high socio-economic status were associated with higher recognition of symptoms (p<0.05). The majority of the survey respondents identified smoking as a cause of lung cancer (90.6%, 95%Confidence Interval (CI) 88.4-92.8) however fewer recognised the risk from second-hand smoke (25.6%,95%CI22.3-28.9). Ever-smokers were less likely to recognise the risk of smoking (odds ratio 0.7 95%CI0.5-0.9).

      Conclusion
      These findings provide evidence that while awareness of lung cancer symptoms and causative factors is reasonably understood in the community, perceived susceptibility is low (particularly among current and former smokers). A lack of urgency in seeking medical attention for symptoms considered not severe, together with other smoking-related barriers, may lead to further delays in diagnosis and missed opportunity for surgical treatment.

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    P3.20 - Poster Session 3 - Early Detection and Screening (ID 174)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Imaging, Staging & Screening
    • Presentations: 1
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      P3.20-008 - Prompting earlier diagnosis of lung cancer: evaluation of a public education campaign in NSW to raise awareness of lung cancer symptoms (ID 2146)

      09:30 - 16:30  |  Author(s): N. Scott

      • Abstract

      Background
      Lung cancer is the leading cause of cancer death for both males and females in New South Wales (NSW), Australia. Similar to other countries, the five-year relative survival rate for lung cancer in NSW is low, reported at 17.6% (2005-07). The poor relative survival rate suggests that in most cases, diagnosis occurs late, predominantly in stage III or IV. A multi-channel public education campaign was implemented in NSW to increase awareness of three symptoms consistent with lung cancer (persistent cough, change in cough and blood in cough) and prompt people experiencing these symptoms to see their General Practitioner (GP) immediately. If people experiencing these symptoms seek a doctor as soon as symptoms are experienced, it has the potential to reduce diagnostic delay and hence, an improvement in the five-year relative survival of lung cancer.

      Methods
      The public education campaign, comprised mass media television advertising implemented over 5 weeks (March/April 2013) at 100 TARPs per week in conjunction with public relations activity and a direct mail communication to GPs across NSW. Quantitative telephone surveys were conducted in July 2012 (pre-campaign) and April 2013 (post-campaign) with adults over 45 years of age residing in NSW (both; n=1000). Unprompted and prompted recall of the campaign were measured and levels of unprompted awareness of symptoms consistent with lung cancer and confidence in recognising symptoms consistent with lung cancer were compared between the two surveys.

      Results
      Overall, 28.7% of the targeted population recalled the campaign unprompted, increasing to 60.5% when prompted. Pre- and post-campaign results demonstrate an increase in unprompted awareness of key lung cancer symptoms emphasised by the campaign; ‘coughing up blood’ (from 39.1% to 45.4% (p = 0.004)), ‘cough that does not go away for two or three weeks’ (from 17.0% to 40.7% (p = <0.001)) but no significant different in awareness of ‘worsening or change in cough’ (6.3% to 4.6% (p = 0.096)). Post-campaign awareness of these symptoms was higher amongst non-smokers than smokers, particularly for persistent cough. Encouragingly, confidence to recognise a symptom increased from 58.8% to 67.4% (p = <0.001).

      Conclusion
      These findings suggest that a mass media public education campaign can be an effective approach to increase awareness of symptoms consistent with lung cancer and confidence in recognising these symptoms. Increased awareness and recognition of symptoms can lead to earlier diagnosis and treatment.