Randomised controlled trial and economic evaluation of a targeted cancer awareness intervention for adults living in deprived areas of the UK

Moriarty, Yvonne; Lau, Mandy; Sewell, Bernadette; Trubey, Rob; Quinn-Scoggins, Harriet; Owen, Sioned; Padgett, Louise; Kolovou, Vasiliki; Hepburn, Julie; Buckle, Peter; Playle, Rebecca; Townson, Julia; Robling, Michael; Gilbert, Stephanie; Dimitropoulou, Polyxeni; Edwards, Adrian; Mitchell, Caroline; Matthews, Maura; Smits, Stephanie; Wood, Fiona; Neal, Richard D.; Brain, Kate; ABACus study team; Jones, Mari; Farr, Angela

Abstract

Background
Cancer outcomes are poor in socioeconomically deprived communities, with low symptom awareness contributing to prolonged help-seeking and advanced disease. Targeted cancer awareness interventions require evaluation.

Methods
This is a randomised controlled trial involving adults aged 40+ years recruited in community and healthcare settings in deprived areas of South Yorkshire and South-East Wales. Intervention: personalised behavioural advice facilitated by a trained lay advisor. Control: usual care. Follow-up at two weeks and six months post-randomisation. Primary outcome: total cancer symptom recognition score two weeks post-randomisation.

Results
Two hundred and thirty-four participants were randomised. The difference in total symptom recognition at two weeks [adjusted mean difference (AMD) 0.6, 95% CI: −0.03, 1.17, p = 0.06] was not statistically significant. Intervention participants reported increased symptom recognition (AMD 0.8, 95% CI: 0.18, 1.37, p = 0.01) and earlier intended presentation (AMD −2.0, 95% CI: −3.02, −0.91, p < 0.001) at six months. “Lesser known” symptom recognition was higher in the intervention arm (2 weeks AMD 0.5, 95% CI: 0.03, 0.97 and six months AMD 0.7, 95% CI: 0.16, 1.17). Implementation cost per participant was £91.34, with no significant between-group differences in healthcare resource use post-intervention.

Conclusions
Improved symptom recognition and earlier anticipated presentation occurred at longer-term follow-up. The ABACus Health Check is a viable low-cost intervention to increase cancer awareness in socioeconomically deprived communities.

Citation

Moriarty, Y., Lau, M., Sewell, B., Trubey, R., Quinn-Scoggins, H., Owen, S., …Farr, A. (2021). Randomised controlled trial and economic evaluation of a targeted cancer awareness intervention for adults living in deprived areas of the UK. British Journal of Cancer, 125(8), 1100-1110. https://doi.org/10.1038/s41416-021-01524-5

• Journal Article Type: Article
• Acceptance Date: Aug 11, 2021
• Online Publication Date: Aug 27, 2021
• Publication Date: Oct 12, 2021
• Deposit Date: Dec 12, 2024
• Journal: British Journal of Cancer
• Print ISSN: 0007-0920
• Electronic ISSN: 1532-1827
• Publisher: Cancer Research UK
• Peer Reviewed: Peer Reviewed
• Volume: 125
• Issue: 8
• Pages: 1100-1110
• DOI: https://doi.org/10.1038/s41416-021-01524-5
• Public URL: https://keele-repository.worktribe.com/output/1014707
• Publisher URL: https://www.nature.com/articles/s41416-021-01524-5
• Additional Information: Received: 7 January 2021; Revised: 6 July 2021; Accepted: 11 August 2021; First Online: 27 August 2021; : The London-Surrey NHS Research Ethics Committee (Ref: 17/LO/1507) approved this trial. UK-wide governance approval was granted from Health and Care Research Wales Permission Service. Written informed consent was taken from all participants in the trial at recruitment. This trial was conducted in accordance with Good Clinical Practice and the Declaration of Helsinki.; : Not applicable.; : The authors declare no competing interests.