Introduction The UK government embarked on two National Bowel Cancer Awareness Campaigns in 2012 to raise public awareness of colorectal cancer (CRC) and to prompt symptomatic individuals to visit their primary care physicians early. A pilot programme in 2011 failed to demonstrate neither increased numbers, nor earlier stage of new CRC diagnosed, despite significant rise in 2WW referrals1. It is unclear whether such findings would translate to other regions of the UK during a nationwide awareness campaign.
To determine the effects of the bowel awareness campaigns on 2WW referrals.
Comparison of the number of CRC cases diagnosed during the campaigns to a comparable period in 2011.
Stage of disease and survival for patients diagnosed during the campaigns.
Methods Retrospective study of over 1439 consecutive patients referred through the 2WW colorectal pathway to Mid-Yorkshire Hospital NHS Trust during the campaigns between 1/2/2012 to 30/4/2012 and 1/9/2013 to 31/10/2012. Total number of referrals, newly diagnosed cases of CRC and non-CRC, with their respective staging were determined and compared with a comparable group in 2011. One year survival for the two groups was evaluated by Kaplan-Meier.
Results Referrals through the 2WW pathway increased by 55–60% during the bowel awareness campaigns, but there was no significant relative increase in CRC or non-CRC diagnoses. Positive diagnostic yield for CRC remained low at 5.6% and 6.1%. The bowel awareness campaigns did not affect the stage at which CRC patients were diagnosed, as over 50% presented with Stage 3 and 4 disease, and similarly there was overall no difference in 1 year survival.
Conclusion The UK bowel awareness campaign has increased public awareness of CRC and prompted symptomatic individuals to seek medical attention. This study shows the increase in 2WW referrals has not translated to better outcomes for patients. Furthermore the study highlights the difficulty in assessing a symptomatic individual’s risk for CRC in primary care, despite current guidelines which carry poor positive predictive value. Better risk assessment tools are desperately required, otherwise, future national campaigns would add significant presures to already overstretched colorectal units.
Taylor M, COI, Radford G, Network. AC. Evaluation of the Bowel Cancer Awareness Pilot in the South West and East of England 31 January to 18 March 2011. Department of Health UK.; 2012
Disclosure of Interest None Declared.