November will see the start of a new cancer awareness study that has been carefully designed to target deprived communities in Wales. These communities carry the greatest burden of cancer across the nation, where the rates of incidence and mortality of some common cancers is up to 20% greater than in other more affluent areas.
The study, titled TIC-TOC (Targeted Intensive Community-based campaign To Optimise Cancer awareness), is funded by Cancer Research Wales and will be led by leading researchers Professor Kate Brain and Dr Grace McCutchan at Cardiff University. The multi-faceted campaign strives to overcome limitations associated with previous cancer awareness campaigns by connecting with the communities of greatest need.
Previous research funded by Cancer Research Wales has demonstrated the challenges that GPs face when presented with vague cancer symptoms, which can occur in up to 50% of all cancer cases. These include unexplained weight loss, loss of appetite, nausea, persistent fatigue, abdominal pain, and “feeling different from your usual self”.
Theoretically underpinned, TIC-TOC builds on these studies to support the key vague symptom component of the newly formed Single Cancer Pathway in Wales, by optimising use of the Rapid Diagnostic Centres (“one-stop diagnostic shops”). The study, which is focussed within Cwm Taf Morgannwg Health Board, will encourage individuals with vague symptoms of cancer to seek medical-help to accelerate referral of patients with concerning symptoms – yet do not conform to the current NG12 primary care cancer referral guidelines. Many conditions, both cancer and non-cancer, can be determined within a day for most people who attend these one-stop diagnostic shops.
By addressing known barriers to help-seeking, the study aims to reduce the time between noticing a symptom and presenting to primary care, without creating the ‘worried well’. Not approaching the GP with symptom concerns was a worrying trend found in Modules 2 and 4 of Phase I of the International Cancer Benchmarking Partnership. Not seeking medical help for potentially serious symptoms may be exaggerated as result of the recent COVID-19 pandemic.
The main intervention of this multi-dimensional community-based awareness study will be delivered over a 6-month period in the second half of 2021. Intervention messages will be disseminated via various media outlets and community channels, such as radio, newspapers, TV interviews with key health care professionals, social media and pharmacies to raise awareness of vague cancer symptoms, highlight the importance of early cancer diagnosis and encourage early help-seeking in adults living in socioeconomically deprived areas.
A major development in this cancer awareness campaign will be the training of five lay cancer champions who will work with community groups and GP practices to deliver campaign messages and support people with vague symptoms to seek medical help. It is envisaged that these trained cancer champions will help the public to spot changes in their health and empower them to visit the doctor, leading to a persistence of cancer awareness in communities where it is needed most.
When complete the feasibility study hopes to establish a future framework to evaluate the campaign nationally to assess longer term outcomes including earlier diagnosis and improved survival in deprived areas.
Ann Tate, CEO of Cancer Research Wales said, ‘Tackling the large cancer inequalities that exist in Wales is a key strategic aim of the Charity. Therefore, Cancer Research Wales is excited to invest in this much needed and unique cancer awareness study. The research team have an impressive track record in the area and we look forward to the final results of the trial that will help improve cancer outcomes and ultimately serve as another step towards improving Wales’ standing in international cancer league tables’.
Dr Grace McCutchan and Grace Kate Brain, study leads, commented:
“This is an exciting opportunity to address known barriers to early symptomatic presentation and support access into Rapid Diagnostic Clinics. The TIC-TOC study will provide evidence regarding the feasibility of implementing and evaluating a vague symptom awareness campaign in an area of high socioeconomic deprivation. We would like to thank Cancer Research Wales for funding this important work.”