Abstract
BackgroundFor some common cancers, survival is lower in the UK than in comparable high-income countries.AimTo assess the effectiveness of a targeted postal intervention (to promote awareness of cancer symptoms and earlier help seeking) on patient consultation rates.Design and settingA two-arm randomised controlled trial was carried out on patients aged 50–84 years registered at 23 general practices in rural and urban areas of Greater London, Greater Manchester, and the North East of England.MethodPatients who had not had a consultation at their general practice in the previous 12 months and had at least two other risk factors for late presentation with cancer were randomised to intervention and control arms. The intervention consisted of a posted letter and leaflet. Primary outcome was the number of consultations at the practice with patients randomised to each arm in the 6 months subsequent to posting the intervention. All patients with outcome data were included in the intention-to-treat analyses.ResultsIn total, 1513 patients were individually randomised to the intervention (n = 783) and control (n = 730) arms between Nov 2016 — May 2017; outcome data were available for 749 and 705 patients, respectively, with a statistically significantly higher rate of consultation in the intervention arm compared with the control arm: 436 versus 335 consultations (relative risk 1.40, 95% confidence interval = 1.11 to 1.77, P = 0.004). There was, however, no difference in the numbers of patients consulting.ConclusionTargeted interventions of this nature can change behaviour; there is a need to develop interventions that can be more effective at engaging patients with primary care. This study demonstrates that targeted interventions promoting both awareness of possible cancer symptoms and earlier health seeking, can change behaviour. There is a need to develop and test interventions that can be more effective at engaging the most at-risk patients.
Highlights
For some common cancers, survival in the UK is lower than in comparable high-income countries.[1]
This study demonstrates that targeted interventions promoting both awareness of possible cancer symptoms and earlier health seeking, can change behaviour
Study design and setting A two-arm randomised controlled trial (RCT) — called Writing to Encourage Late Consultation Outpatients to Make Engagement with their GP (WELCOME-GP) — was carried out to test the effectiveness of a postal intervention that was targeted at certain vulnerable groups and intended to promote awareness of cancer symptoms and earlier help seeking at general practice
Summary
For some common cancers (including lung, colorectal, and breast cancer), survival in the UK is lower than in comparable high-income countries.[1] It is thought that this is due largely to later-stage disease at diagnosis in the UK. This may be partly related to system delays following presentation, some of which have increased over the last decade in England;[2] it may arise from low symptom awareness, negative beliefs about cancer, and reluctance to ‘waste the doctor’s time’3,4 — all of which could extend the patient interval.[5] There is a positive association between levels of awareness of cancer and survival.[6] In addition, there remain geographic and socioeconomic inequalities in cancer survival, the gap has narrowed somewhat in recent years.[7,8]. Survival is lower in the UK than in comparable high-income countries
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
