Evaluation of an educational programme for the early detection of cancer
Introduction
Our methods for treating cancer have been improving during the last few decades. There is, however, still a high patient’s and doctor’s delay. The effect of screening for cancer has been debated and studies have concluded that screening for cervical cancer [1], breast cancer [2] and colorectal cancer [3] will result in a reduction in mortality [4]. Another possible way of shortening patient’s delay might be to increase the knowledge in the general population [5] about cancer symptoms, another to increase the knowledge of GPs and other health care personnel [6] about how to take care of potential cancer symptoms, in order to influence doctor’s delay in a favourable way. The purpose of this study was to evaluate the effects of an educational programme for early detection of cancer (EPEDC) in primary health care in terms of reducing the patient’s and doctor’s delay; to describe the common characteristics of subjects with cancer-related symptoms; to determine the potential anxiety caused by the EPEDC; and to detect other treatable diseases.
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Design and setting
The study had a pre-experimental design (the one-group post-test only design) and was carried out in the north-eastern part of Gothenburg situated on the Swedish west coast.
Study population
The study area had about 77 100 inhabitants, 38 700 men and 38 400 women, and was served by six health centres. The EPEDC was distributed to 32 627 inhabitants, 40 years of age or older. The EPEDC was first carried out in a pilot area with 4039 inhabitants, of the same age as above (Fig. 1). The area had a low socio-economic
Participation
The EPEDC was sent to 32 627 inhabitants 40 years of age or older, 4039 of whom were living in the pilot area (Fig. 1). One hundred and thirty two persons (3%) in the pilot area contacted the health centre by telephone because of the EPEDC. The results from the pilot area did not differ from the main area, and the results are therefore presented together. There were in all 234 visits to the health centres (139 men and 95 women) corresponding to 0.7% of the study population in total.
Prevalence of cancer observed as a result of the EPEDC
As shown in
Discussion
There are three main ways of acquiring an earlier diagnosis of cancer: screening, education of the public, and improvement of our diagnostic methods [11]. This study was an evaluation of an EPEDC for the population and for the health centres. The American Cancer Society [6] and corresponding organisations in Canada [12] and Europe [13] have published guidelines for health centres. There is, however, on the whole very little described in the literature about EPEDC concerning signs and symptoms
Conclusions and implications
Reducing the delay between onset of symptoms and treatment by reducing the patient’s delay should be a goal for improving the survival of cancer patients. We could, by means of an EPEDC about cancer symptoms for the general population, diagnose some previously unknown cancers. The EPEDC may have shortened patient’s delay, but the study does not allow conclusions concerning this question. More experience is necessary, and it seems that more effective methods should be looked for. The overall
Acknowledgements
The investigation was performed with help from staff in the health centres of Lövgärdet, Angered, Hjällbo, Bergsjön, Kortedala and Gamlestaden. The questionnaire about the attitudes was selected from a study with reference to colorectal cancer, with help from Elisabet Lövendahl and Eva Haglind at the Department of Surgery, Sahlgrenska University Hospital in Gothenburg. The information about the local cancer incidence was obtained from Erik Holmberg at the Oncology Center, Sahlgrenska University
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