Be Clear on Cancer: Bowel cancer campaign information

The Department of Health appointed the agency M&C Saatchi 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 of bowel, breast and lung cancer. It is now being expanded to look at new areas: the symptom blood in urine (a symptom common to bladder and kidney cancers); breast cancer in women over 70 and oesophago-gastric cancer.

The Department of Health used existing insight which has been building over recent years. This includes qualitative research with GPs, undertaken by Cancer Research UK and DH, on the reasons why they think patients delay presenting with cancer symptoms. The DH worked with a panel of experts to help develop the creative concepts for the advertisements. This included representatives from different disciplines including; public health, primary care, secondary care, academic research and communications. The creative approach was also tested with GPs through qualitative research.

In addition to all this work at the development phase, the DH has continued to engage with health professionals throughout the development process to learn and adapt the Be Clear on Cancer brand.

Public awareness of key symptoms of cancer is low. Research also shows that for some cancers, people from lower socio economic backgrounds or people who have lower levels of education tend to delay seeing their GP (Macleod et al, 2009). While it will depend on the tumour type, for most activities the target audience for Be Clear on Cancer is primarily men and women from lower socio-economic groups over the age of 50. The bowel cancer campaign is aimed at those over 55.
You can find information about the incidence, survival, mortality rates and risk factors for bowel cancer here.

Two pilots for bowel cancer using the Be Clear on Cancer brand ran in the early part of 2011. Results from the regional pilots in the South West and East of England, found:

• There was a 48% increase in the number of people who visited their GPs with relevant symptoms
• There was a 32% increase in urgent referrals to hospitals over six months – which included the period the campaign ran
• Campaign recognition was high with 75% of the public in South West and East of England saying they had seen the advertising
• There was overwhelming support for the campaign – 96% of the public agreed that ‘it’s important that ads like these are shown’. The figure was 89% amongst GPs.

The Department of Health has used what it has learnt from the bowel cancer pilot and local activities on raising awareness that have run over the last few years to help develop the Be Clear on Cancer activity.

With over 14 opportunities for each person to see the TV advert alone during the course of the campaign - not to mention the additional opportunities for people to see or hear more on the radio, in national press and in their local communities - it is hoped that the new national Be Clear on Cancer bowel campaign will follow the success of the regional pilot campaign by raising awareness and encouraging those with symptoms to seek help.

The Department of Health has tested the creative concepts and brand with men and women from different ethnic minority communities, different socio-economic groups and different regions across England. This qualitative research comprised 20 group discussions and in-depth interviews with GPs. The creative materials and key messages were developed in consultation with a Campaign Advisory Group, which included primary and secondary care clinicians, cancer charities, cancer networks and regional communications teams.

A number of PCTs across England have already used Be Clear on Cancer for bowel cancer in their communities and, although results of their activities are still coming in, anecdotally we know that it has resonated with their audiences.

By working with your teams and other colleagues and spreading the Be Clear on Cancer message when patients come to your practice or your pharmacy, it is possible to show how the core message is relevant to your local community. You can also promote the Be Clear on Cancer campaign by adding a link on your website to the Department of Health’s dedicated page on NHS Choices: www.nhs.uk/bowelcancer 

The Department of Health’s qualitative research findings had told us that whilst Be Clear on Cancer researched well with ethnic minority people who are fluent in English, within some communities (the Pakistani and Bangladeshi communities in particular) there is a considerable cohort 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 (particularly true of the older generation).

Rather than create an entirely new campaign for these communities, the Department of Health decided to make use of an existing bowel cancer awareness campaign which was developed by the Greater Manchester Public Health 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.  In order to provide a link between the two campaigns, the press and TV advertising for ‘Detect Cancer Early’ also carry Be Clear on Cancer branding and there are links on the NHS Choices website to the Detect Cancer Early website, which offers information in a range of South-Asian languages.   

Be Clear on Cancer has been developed for bowel, lung, breast and blood in urine, as a symptom of bladder and kidney cancer. An additional breast cancer version specifically for women over 70 years has been developed. Oesophago-gastric cancer will be added to the suite of materials for Be Clear on Cancer in early 2012.

From 30 January 2012, the Department of Health will run the first national bowel cancer campaign to raise public awareness of the symptoms of bowel cancer and help improve earlier diagnosis.  The campaign will feature on national TV, radio and press, as well as on buses, pharmacy bags, TV screens in GP practices and online, providing people with multiple opportunities to see the Be Clear on Cancer message.

Meanwhile, lung cancer became the focus of a regional pilot in the Midlands, running from 10 October to 13 November 2011, and 18 new local projects are piloting activities to raise awareness of the symptom of blood in urine (for bladder and kidney cancers), breast cancer in women over 70, oesophago-gastric cancer and lung cancer in 2012.

Yes. There are briefing sheets for GPs and for the wider practice team. There is also a briefing sheet for pharmacists and pharmacy counter staff.

If you would like more information about the Department of Health’s Be Clear on Cancer campaign, please email naedi@cancer.org.uk and ensure you include Be Clear on Cancer in the title of your email.

*When the bowel cancer pilot ran in the South West and East of England, campaign recognition was 75% amongst the general public within these regions.