Bowel cancer campaign

Be Clear on Cancer logo for bowel campaign

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The Be Clear on Cancer campaign aims to raise awareness of the symptoms of bowel cancer, and to encourage people who have the key symptoms to go to their GP without delay. The first regional pilot ran from January to March 2011 and then nationally for the first time from January to March 2012. A 'reminder' campaign ran from August to September 2012 to keep the message front of mind. Following that, three areas of England (North London, North East London, North West England and Yorkshire) piloted different approaches to keeping the campaign running from October 2012 to Mid-March 2013.

The campaign highlighted two key symptoms of bowel cancer: See your doctor straight away if, for the last three weeks, you’ve had blood in your poo or looser poo.

The aim of the campaign was to encourage more people with these symptoms to go and see their GP earlier.

A number of resources were created for the BCOC campaign including briefing sheets and patient materials. Below is an example from the 2012 campaign:

Men and women from lower socioeconomic groups over the age of 55, and the people who influence them, such as friends and family.

Screening is a very important part of diagnosing bowel cancer early and it is referenced in the Be Clear on Cancer leaflet that the Department of Health produced. The Be Clear on Cancer campaign aimed to target symptomatic patients, therefore screening was not mentioned in the TV advert or posters. The reason for this approach, was to keep the campaign message simple and direct.

Bowel cancer is the third most common cancer in the UK. Around 34,000 people are diagnosed with bowel cancer [1] in England every year and around 13,200 people die from the disease [2].

Outcomes in the UK are worse than those in comparable European countries and it is estimated that around 1,700 deaths from bowel cancer could be avoided each year if survival rates were as good as the best in Europe.

Over 93% of bowel cancer patients diagnosed with the earliest stage of the disease survive five years, compared with less than 7% of those diagnosed when the disease is at the most advanced stage . Only 9% of patients in England are currently diagnosed with bowel cancer when it is at the earliest stage

Percentage of cases and five-year relative survival by Duke's stage at diagnosis
Colorectal patients diagnosed 1006-2002, England

Duke stage at diagnosis Percentage of cases Five-year relative survival
A 8.7% 93.2%
B 24.2% 77.0%
C 23.6% 47.7%
D 9.2% 6.6%
Unknown 34.3% 35.4%

Prepared by Cancer Research UK

Source: Colorectal Survival by Stage,. NICN, accessed May 2012


  1. Data were provided by the Office for National Statistics on request, June 2012. Similar data can be found here: is external)
  2. Office for National Statistics Mortality Statistics: Deaths registered in 2010, England and Wales 2010, National Statistics: London

The initial findings following the first national campaign have been positive:

  • An increase in referrals for the over 50s. More than 85% of the referrals in February to March 2012 were in people aged 50 or over.
  • Statistically significant increases in the public’s unprompted awareness of blood in poo (27% to 42%) and looser poo (10% to 23%).
  • Statistically significant increase in the public’s confidence in knowing the signs and symptoms of bowel cancer.
    Increase in urgent referrals to hospitals compared to the same period in the previous year – more than 85% of the referrals were in people aged over 50.

Data on GP attendance, cancers diagnosed and staging will also be analysed and included in the evaluation of the national campaign, but some of this information is not yet available.

In March 2015, the British Journal of Cancer (BJC) published the second NAEDI supplement. The publication showcases a series of papers presenting current evidence on early diagnosis across the patient pathway. As part of the BJC supplement, Moffat et al. (2015) investigated the impact of the Be Clear on Cancer national bowel and lung cancer campaigns. The paper looked at public awareness and GP attendance with symptoms highlighted in the campaigns on samples of the population sub-grouped by gender, age and socioeconomic status.

View "The impact of national cancer awareness campaigns for bowel and lung cancer symptoms on sociodemographic inequalities in immediate key symptom awareness and GP attendance"

Power and Wardle (2015) looked at existing data from the Cancer Awareness Measure (CAM) to examine the impact of the Be Clear on Cancer campaigns on public awareness of key symptoms of lung and bowel cancer and perceived barriers to seeing a doctor.

View “Change in public awareness of symptoms and perceived barriers to seeing a doctor following Be Clear on Cancer campaigns in England”