{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T11:50:24Z","timestamp":1780919424132,"version":"3.54.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T00:00:00Z","timestamp":1576454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T00:00:00Z","timestamp":1576454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Br J Cancer"],"published-print":{"date-parts":[[2020,2,18]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Lung cancer is the leading cause of cancer mortality in Wales. We conducted a before- and after- study to evaluate the impact of a four-week mass-media campaign on awareness, presentation behaviour and lung cancer outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Population-representative samples were surveyed for cough symptom recall\/recognition and worry about wasting doctors\u2019 time pre-campaign (June 2016; <jats:italic>n<\/jats:italic>\u2009=\u20091001) and post-campaign (September 2016; <jats:italic>n<\/jats:italic>\u2009=\u20091013). GP cough symptom visits, urgent suspected cancer (USC) referrals, GP-ordered radiology, new lung cancer diagnoses and stage at diagnosis were compared using routine data during the campaign (July\u2013August 2016) and corresponding control (July\u2013August 2015) periods.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Increased cough symptom recall (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), recognition (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and decreased worry (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were observed. GP visits for cough increased by 29% in the target 50+ age-group during the campaign (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and GP-ordered chest X-rays increased by 23% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). There was no statistically significant change in USC referrals (<jats:italic>p<\/jats:italic>\u2009=\u20090.82), new (<jats:italic>p<\/jats:italic>\u2009=\u20090.70) or early stage (<jats:italic>p<\/jats:italic>\u2009=\u20090.27) diagnoses, or in routes to diagnosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Symptom awareness, presentation and GP-ordered chest X-rays increased during the campaign but did not translate into increased USC referrals or clinical outcomes changes. Short campaign duration and follow-up, and the small number of new lung cancer cases observed may have hampered detection effects.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1038\/s41416-019-0676-2","type":"journal-article","created":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T00:02:48Z","timestamp":1576454568000},"page":"491-497","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Evaluation of a national lung cancer symptom awareness campaign in Wales"],"prefix":"10.1038","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8079-2540","authenticated-orcid":false,"given":"Grace","family":"McCutchan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Smits","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Ironmonger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciar\u00e1n","family":"Slyne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Boughey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodie","family":"Moffat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dyfed Wyn","family":"Huws","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Brain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,12,16]]},"reference":[{"key":"676_CR1","doi-asserted-by":"publisher","first-page":"394","DOI":"10.3322\/caac.21492","volume":"68","author":"F Bray","year":"2018","unstructured":"Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R., Torre, L. & Jemal, A. 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Cancer"}],"container-title":["British Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.nature.com\/articles\/s41416-019-0676-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.nature.com\/articles\/s41416-019-0676-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.nature.com\/articles\/s41416-019-0676-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T21:06:24Z","timestamp":1684616784000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41416-019-0676-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,16]]},"references-count":25,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,2,18]]}},"alternative-id":["676"],"URL":"https:\/\/doi.org\/10.1038\/s41416-019-0676-2","relation":{},"ISSN":["0007-0920","1532-1827"],"issn-type":[{"value":"0007-0920","type":"print"},{"value":"1532-1827","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,16]]},"assertion":[{"value":"19 July 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 November 2019","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 November 2019","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 December 2019","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The survey was conducted as part of an omnibus survey conducted by Beaufort\u2019s Research; therefore, ethical approval was not obtained for the omnibus. Beaufort Research operate to standard codes of conduct.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"Requests for data-sharing will be considered by the senior authors. Please submit requests to the corresponding author.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The pre-campaign testing and elements of the evaluation were funded by the Early Diagnosis team at Cancer Research UK. Public Health England funded the development of the assets used in the campaign. NHS Wales funded the Welsh campaign and evaluation. Dr Grace McCutchan is supported by Health and Care Research Wales as part of the Wales Cancer Research Centre (Grant reference no: CA05). Dr Stephanie Smits is supported by a Health and Care Research Wales Fellowship.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding information"}}]}}