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PTU-023 The 2015 “Be Clear On Cancer” Campaign: Its Impact on Gastroenterology Referral Rates and Cancer Diagnosis: A Twin-Centre Review
  1. K Siau1,
  2. S Hingley2,
  3. A Veitch3,
  4. N Fisher2
  1. 1Department of Gastroenterology, Royal Wolverhampton NHS Trust, Wolverhampton
  2. 2Department of Gastroenterology, Dudley Group NHS Foundation Trust, Dudley
  3. 3Department of Gastroenterology, Royal Wolverhampton Hospital NHS Trust, Wolverhampton, UK

Abstract

Introduction The “Be Clear on Cancer” campaign was launched by Public Health England to raise awareness of gastro-oesophageal cancers, and ran for four weeks from January to February 2015.1 The key message advertised on television was: ‘Having heartburn, most days, for 3 weeks or more, could be a sign of cancer – tell your doctor.’ We aimed to measure how this campaign affected the following: 1) 2 WW gastroscopy referrals, 2) incidence of target diagnoses (Barrett’s and gastro-oesophageal cancer, 3) stage of cancers at diagnosis, 4) cancer survival.

Methods We performed a retrospective study using pooled data from 2 NHS trusts (Royal Wolverhampton and Dudley Group NHS Trust), with a combined population of 699000 in 2014 and 798000 in 2015. Patients referred for 2 WW open access endoscopy for 3 months after campaign start (Feb to April 2015) were identified from Trust clinical databases. Diagnoses, endoscopy, staging, and 9 month survival were compared with data from corresponding months in 2014. Analyses were performed using Fisher’s exact and t-test.

Results 832 referrals were received in the 3 months of 2015, compared with 519 in 2014. After adjusting for population, 2 WW endoscopy demand had increased by 40.4% (p < 0.03). 63 cases of Barrett’s and carcinoma were diagnosed in 2015, compared with 50 cases in 2015. Overall, there was 10.4% increase in detection of significant diagnoses (p = 0.6). 23 cases of oesophageal malignancy were detected, compared with 19 in 2014. The incidence of gastro-oesophageal cancer was 11.5 per 100,000 in 2015, compared with 10.8 per 100,000 population in 2014 (relative increase of 6%, p = 0.85). Due to the increase in gastroscopies performed, the yield of significant diagnoses fell from 8.0% in 2014 to 6.7% in 2015. 8/20 patients had presented with T2 or earlier stage of oesophageal cancer, compared with 3/16 in 2014 (odds ratio 2.9 for ≤T2 disease, p = 0.28). 8/20 had localised disease (N0 and M0) in 2015, with 6/18 in 2014 (OR 1.33 for localised disease, p = 0.74). The unadjusted 9 month mortality rates were 38% (10/28) in 2015 and 52% (12/23) (OR for 9 month survival in 2015 was 0.57, p = 0.39).

Conclusion The “Be Clear on Cancer” campaign significantly increased the demand for 2 WW gastroscopies. A trend towards a higher incidence of Barrett’s or cancer diagnosis was noted, although the overall yield of endoscopy procedures was lower. The odds ratios appear promising for diagnostic yield, earlier presentation and 9 month survival but this was not statistically significant. Larger studies are required to validate our findings.

Disclosure of Interest None Declared

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