Breast cancer in women over 70 campaign
For information about breast cancer symptoms for the public, check out our webpage
Public awareness of the signs and symptoms of cancer can support timely presentation in primary care and drive earlier diagnosis. Be Clear on Cancer (BCOC) campaigns were carried out to raise awareness of key symptoms of cancer and encourage people to go to their GP without delay.
Why were the campaigns run?
Breast cancer is the most common cancer in the UK [1]. Breast cancer risk increases with age and a third of women diagnosed with the disease are aged 70 and over [2].
Women over 70 are not routinely invited for breast screening. The International Agency for Research on Cancer (IARC) evaluated the evidence on breast cancer screening in March 2002 and concluded that trials have provided sufficient evidence for the screening of women between 50 and 69 years. In 2012, an independent review was conducted to understand the risks and benefits of breast screening; you can find out more in our blog.
Research shows that older women are less aware of non-lump breast cancer signs and symptoms [3], are more likely to worry about wasting their doctor’s time [4] and delay presenting to their doctor with possible cancer symptoms [5]. Older women also have poorer knowledge that breast cancer risk increases with age, and this may be due to women incorrectly assuming they are no longer at risk of developing the disease after routine NHS breast screening invitations have ended [6]. Women aged 70 and over are still entitled to NHS breast screening every three years – they just need to make their own appointment via their GP.
National BCOC campaigns to raise awareness of breast cancer in women over 70 took place from February to March 2014 and again from July to September 2015 in England.
Who did the campaigns target?
This campaign targeted women over 70 years old. More than half of women who die from their breast cancer in England each year were aged 70 and over [8]. The aim was to encourage more women aged 70 and over with unusual breast symptoms to go and see their GP.
What were the key messages?
The key message promoted was '1 in 3 women who get breast cancer are over 70, so don't assume you're past it.' The advertising informed women over 70 that if they see any changes to their breasts, they should see their doctor straight away.
A second message, promoted more prominently in other campaign materials, was: ‘A lump isn’t the only sign of breast cancer. If you’re worried about any changes to your breasts, tell your doctor straight away.’
Communication plans for the campaign included:
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TV advertising ran for eight weeks: It was expected that the target audience saw the advert about 8 times on average.
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Press adverts: This included display adverts in newspapers and women's magazines, together with advertorials which enable more details to be provided.
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Out of home advertising: Included promotion of the campaign’s messages on pharmacy bags.
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Targeting BME audiences: Events were also held in key locations relevant to BME communities.
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Social media: Due to the increasing number of older women using the internet, advertising was also featured in key channels, such as Facebook.
What was the impact of the campaigns?
A regional ‘breast cancer in women over 70’ pilot campaign ran across the Midlands from January to March 2013. Research after the campaign identified a significant uplift in people agreeing that one in three women who get breast cancer are aged over 70, from 16% to 25%. When comparing the campaign period with the same time the previous year, the results for women aged 70 and over were:
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A significant 11% increase in 2WW referrals for both suspected breast cancer and non-suspected breast cancer symptoms within the regional pilot campaign area, compared with 5% increase seen in control areas.
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A significant 7% increase in the number of breast cancer cases diagnosed following a 2WW referral for suspected breast cancer or non-suspected breast cancer symptoms in the regional pilot area.
A national ‘breast cancer in women over 70’ campaign ran across England from February to March 2014. When comparing 2012 (base year for referral data due to the regional campaign in 2013) with 2014, the results for women aged 70 and over show:
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A significant 64% increase in two-week-wait referrals for suspected breast cancer and a significant 75% increase in non-suspected breast cancer symptoms (combined referrals, 67% increase).
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A significant 25% increase in the number of breast cancers diagnosed via a two-week-wait referral.
When taking other routes to diagnosis into account (including breast screening), the total number of women aged over 70, diagnosed with breast cancer following the campaign, significantly increased by 31%.
The impact of all the campaigns was evaluated and published: Impact of the third national ‘Be Clear on Cancer’ Breast Cancer in Women over 70 Campaign on general practitioner attendance and referral, diagnosis rates and prevalence awareness (Eberhardt et al., 2022)
Resources
Resources to explain the campaign were developed and shared with relevant groups.
Public facing resources to promote the campaigns were developed in a range of accessible formats.
View the British Sign Language version of the campaign leaflet:
References
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Cancer Research UK, Cancer Statistics
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Incidence data supplied by West Midlands KIT based on NCRS data.
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Linsell L, Burgess CC and Ramirez AJ. Breast cancer awareness among older women. Br J Cancer. 2008.
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Forbes, L. et al. Awareness of breast cancer among women living in inner North East London. King’s College London. 2010.
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Ramirez AJ, et al. Factors predicting delayed presentation of symptomatic breast cancer: a systematic review. Lancet. 1999.
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Age is just a number: the report of the parliamentary inquiry into older age and breast cancer. The All Party Parliamentary Group on Breast Cancer. 2013.
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Lavelle, K. et al. Non-standard management of breast cancer increases with age in the UK: a population based cohort of women > 65 years. Br J Cancer 2007.
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Death data supplied by West Midlands KIT based on ONS data.
Be Clear on Cancer statement
Be Clear on Cancer was a cancer awareness campaign led by Public Health England, working in partnership with the Department of Health and NHS England. This page contains links to documents that we hope you find useful. Please note however that the views or opinions expressed within those links are not necessarily those of Cancer Research UK.