About Be Clear on Cancer
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Be Clear on Cancer campaigns aim to improve early diagnosis of cancer by raising public awareness of signs and/or symptoms of cancer, and to encourage people to see their GP without delay. The programme is led by Public Health England, working in partnership with the Department of Health, NHS England and Cancer Research UK. Each campaign is tested locally and then regionally, with a view to rolling them out nationally if they prove to be effective.
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The Department of Health appointed the agency M&C Saatchi in 2010 and together they created the Be Clear on Cancer brand. Be Clear on Cancer has been in use since January 2011 to promote awareness and early diagnosis.
Be Clear on Cancer has been developed for bowel, lung, breast, blood in urine (as a symptom of bladder and kidney cancer), oesophago-gastric and ovarian cancers. An additional breast cancer campaign specifically for women over 70 years and a cancer symptoms campaign called 'Know 4 sure' have also been developed.
Initially the Department of Health used existing evidence and insight which had been building over recent years to create the brand concept. This included qualitative research with GP's undertaken by Cancer Research UK and the Department of Health, on the reasons they think patients delay presenting with cancer symptoms.
For each campaign the Department of Health then worked with a panel of experts to help develop the individual creative concepts and key messages for the advertisements. This included representatives from different disciplines including; public health, primary care, secondary care, charity sector, academic research and communications. The creative approach for each campaign was tested with GPs as well as the target audience, through qualitative research.
In addition to all this work at the development phase, the Department of Health has continued to engage with health professionals at every stage of the programme of work over the past three years to learn from their experiences and develop the Be Clear on Cancer brand.
While it will depend on the cancer type, for most activities the target audience for Be Clear on Cancer is primarily men and women from lower socio-economic groups who are over the age of 50. Public awareness of key symptoms of cancer is low and research shows that for some cancers, people from lower socio-economic backgrounds or people who have lower education levels tend to delay seeing their GP (Macleod et al, 2009). Furthermore cancer incidence rises dramatically with age.
Cancer Research UK was appointed in 2011 to help develop the evaluation framework for the Be Clear on Cancer programme. Cancer Research UK leads on the evaluation of any campaigns which took place before the end of March 2013. Reflecting new structures from April 2013, the National Cancer Intelligence Network (NCIN), as part of Public Health England, was responsible for evaluation of campaigns which took place from 1 April 2013 onwards.
Department of Health, NHS England and Public Health England regularly review data and anecdotal feedback from a range of experts and colleagues from all levels of campaign activity including local and regional pilots, and national campaigns. The information is used to help shape and develop the overall programme of work.
Results from previous campaigns are highlighted in "Improving Outcomes: A Strategy for Cancer Third Annual Report" published in December:
A summary of the Be Clear on Cancer results was developed by Cancer Research UK:
The Be Clear on Cancer materials and key messages were developed in consultation with Campaign Advisory Groups, which included primary and secondary care clinicians, charities, Cancer Networks and regional communications teams.
During the development of each Be Clear on Cancer campaign, the Department of Health thoroughly tested the creative and key messages with men and women from different ethnic minority communities, different socio-economic groups and different regions across England. This qualitative research comprised group discussions, hall tests and in-depth interviews to make sure key messages were clear and understood. Campaigns are also tested with GPs through in-depth interviews.
A number of local NHS teams across England have used Be Clear on Cancer in their communities since 2011 and we know from results, their activities and anecdotal feedback that it has resonated with their audiences.
By talking to people in the community when working with colleagues or by spreading the Be Clear on Cancer message, when patients come to the surgery or pharmacy setting, it is possible to give the core brand a local feel.
The qualitative research findings had told us that whilst Be Clear on Cancer generally researched well with ethnic minority people who are fluent in English, within some communities (the Pakistani and Bangladeshi communities in particular) there is a group within the Be Clear on Cancer target audience who have less fluency and literacy in English and prefer to be communicated with in their mother tongue (this can be particularly true of the older generation). In some communities particularly amongst older women there are also high levels of illiteracy in their mother tongue, so other forms of non-written communication are required i.e face to face, outreach etc.
Rather than create an entirely new campaign for these communities, the Department of Health decided to make use of an existing cancer awareness campaign which was developed by the Greater Manchester Public Health Network and the Greater Manchester & Cheshire Cancer Network to target the South Asian audience in a range of relevant languages. The campaign, ‘Detect Cancer Early’ has researched well and the messaging is very similar to that of Be Clear on Cancer.
The Be Clear on Cancer programme has been developed in response to the Department of Health's 'Improving Outcomes - A strategy for Cancer', which set out how it will seek to achieve the ambition to prevent 5,000 deaths from cancer per year by 2014/15, bringing survival rates in England up to average for Europe. The Government's strategy for cancer includes a range of actions to improve cancer outcomes, including:
- Reducing the incidence of cancers which are preventable, by making lifestyle changes;
- Improving uptake of screening and introducing new screening programmes where there is evidence to justify them;
- Achieving earlier diagnosis of cancer, to increase the scope for successful treatment;
- Making sure that all patients have access to the best possible treatment, care and support.
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