Quality standard

Quality statement 1: Public awareness

Quality statement

Local authorities and healthcare commissioning groups use coordinated campaigns to raise awareness of the symptoms and signs of lung cancer and encourage people to seek medical advice if they need to. [2012, updated 2019]

Rationale

Diagnosing lung cancer at a late stage is associated with poor health outcomes, including shorter survival. Raising awareness of the symptoms and signs of lung cancer can encourage earlier presentation and diagnosis, including among people who have never smoked. Locally coordinated awareness campaigns can engage groups at risk in the local population. Earlier diagnosis will increase the number of adults with lung cancer able to have treatment with curative intent.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

a) Evidence of local needs assessment to identify population groups for campaigns to raise awareness of the symptoms and signs of lung cancer and encourage people to seek medical advice if they need to.

Data source: Local data collection, for example, joint strategic needs assessment.

b) Evidence of locally coordinated campaigns to raise awareness of the symptoms and signs of lung cancer and encourage people to seek medical advice if they need to.

Data source: Local data collection, for example, campaign plans or materials such as posters, leaflets, and social media messaging.

c) Evidence of evaluation of locally coordinated campaigns to raise awareness of the symptoms and signs of lung cancer and encourage people to seek medical advice if they need to.

Data source: Local data collection, for example, evaluation reports.

Outcome

a) Proportion of adults in the population who can recognise and recall the symptoms and signs of lung cancer.

Numerator – the number in the denominator who can recognise and recall the symptoms and signs of lung cancer.

Denominator – the number of adults in the population.

Data source: Local data collection, for example, a sample survey based on Cancer Research UK's Cancer Awareness Measure.

b) Proportion of adults with a new diagnosis of lung cancer who were diagnosed via an emergency route.

Numerator – the number in the denominator who were diagnosed via an emergency route.

Denominator – the number of adults with a new diagnosis of lung cancer.

Data source: National Cancer Registration and Analysis Service Cancer Outcomes and Services Dataset collects data on the source of referral.

c) Proportion of adults with a new diagnosis of lung cancer diagnosed at stage I or II.

Numerator – the number in the denominator diagnosed at stage I or II.

Denominator – the number of adults with a new diagnosis of lung cancer.

Data source: National Cancer Registration and Analysis Service Cancer Outcomes and Services Dataset.

What the quality statement means for different audiences

Local authorities and healthcare commissioning groups work together to develop and implement campaigns, tailored to the needs of the local population, to raise awareness of the symptoms and signs of lung cancer and encourage people to seek medical advice if they need to. They may also promote national lung cancer awareness campaigns locally. Local authorities and healthcare commissioning groups evaluate the impact of local campaigns, including the level of engagement with high‑risk groups.

Health and social care practitioners (such as GPs, practice nurses, district nurses, community pharmacists and social care practitioners) get involved in local campaigns to raise awareness of the symptoms and signs of lung cancer and encourage people to seek medical advice if they need to.

People know about the symptoms and signs of lung cancer and are encouraged to get medical advice if they are worried about any symptoms. People know that getting advice quickly means that any cancer is more likely to be treated successfully.

Source guidance

Lung cancer: diagnosis and management. NICE guideline NG122 (2019), recommendation 1.1.1

Definitions of terms used in this quality statement

Symptoms and signs of lung cancer

Symptoms and signs of lung cancer that should be investigated include:

  • 2 or more of the following unexplained symptoms in people aged 40 years and over, or 1 or more in people aged 40 years or over who have ever smoked:

    • cough

    • fatigue

    • shortness of breath

    • chest pain

    • weight loss

    • appetite loss

  • any of the following in people aged 40 years and over:

    • unexplained haemoptysis

    • persistent or recurrent chest infection

    • finger clubbing

    • supraclavicular lymphadenopathy or persistent cervical lymphadenopathy

    • chest signs consistent with lung cancer

    • thrombocytosis.

[NICE's guideline on suspected cancer: recognition and referral, recommendations 1.1.1 to 1.1.3]

Equality and diversity considerations

Local authorities and healthcare commissioning groups should ensure that awareness campaigns include approaches that engage people living in socioeconomically deprived areas. Awareness campaigns should also be accessible to people who do not speak or read English.