Elsevier

Cancer Epidemiology

Volume 33, Issues 3–4, October 2009, Pages 194-200
Cancer Epidemiology

Some signals cannot wait: Effects of a national campaign on early detection of cancer among Dutch adults (>55 years)

https://doi.org/10.1016/j.canep.2009.07.005Get rights and content

Abstract

Background: The present study examined the effects of the campaign “early detection of cancer” on knowledge, attitudes, awareness, and intention to perform passive detection and timely seeking medical help. Further, the campaign was evaluated on recall and recognition and the various campaign components were evaluated. Methods: A longitudinal study using a Solomon four-group design among 784 Dutch adults aged 55 years and older was conducted. Data was gathered by means of telephone interviews. Results: The results showed moderate levels of campaign awareness. After the campaign, solely respondents who received a pre-test questionnaire and were aware of the campaign had significant higher cancer knowledge levels regarding passive detection. Respondents who were only aware of the campaign were significantly more willing to perform passive detection behavior and to timely seek medical help in the future. Further, they were more aware that paying attention to cancer warning signs can lead to early detection of cancer. Conclusions: It can be concluded that solely the combination of the pre-test questionnaire and exposure to the campaign had a significant positive impact on respondents’ cancer knowledge levels. The effects of the campaign on intention and awareness are indistinct and could be a consequence of (the results of) a self-selection bias. It seems that the dose, frequency, and duration of the campaign should be increased in order to substantiate the effects of the campaign.

Introduction

In the Netherlands, cancer is the second most frequent cause of death and accounted for almost 40,000 deaths in 2007 [1]. Survival rates for most cancers increase if the disease is detected at an early stage [2]. Awareness of possible cancer warning signs may affect successful early detection [2], [3]. Although some cancers, like breast cancer, may be detected at an early stage by screening programs, the majority of cancers symptoms have to be noticed by the patient and pointed out to their physician in order to be detected and diagnosed [4].

People may become aware of possible cancer warning signs by actively detecting cancer warning signs, like regularly inspection of the skin to detect possible changes in moles (i.e., active self-detection) [5]. A person may also detect possible warning signs by being attentive to possible warning signs, like becoming aware of changes in moles (passive detection) [5]. Delays in self-detection and medical help seeking may occur, which decreases the chances of diagnosis at an early stage of the disease.

Knowledge and awareness of cancer warning signs is an important stipulation for adequate performance of early self-detection. Previous national and international studies showed significant deficiencies in public knowledge levels of cancer symptoms [3], [4], [6], [7], [8]. Moreover, other psychosocial correlates, like attitudes and self-efficacy beliefs regarding attentiveness and timely medical help seeking, appear to be positively associated with early detection behavior [6], [7].

In influencing (community) beliefs concerning the early detection of cancer, mass media campaigns are considered a prominent tool for disseminating information. Moreover, they can reach large numbers of people and are relatively low in costs [9], [10]. In order to increase the public's knowledge and awareness regarding early detection of possible cancer warning signs, the Dutch Cancer Society developed and launched a national campaign on early detection of cancer in November 2004. Considering the increased risk of developing cancer for the elderly individuals [11], the campaign was targeted at Dutch adults aged 55 years or older. By means of several channels and activities, individuals were encouraged to be attentive to possible cancer warning signs and timely seek medical help when such symptoms were detected.

The present study assesses the effects of this campaign on knowledge of cancer symptoms, attitudes towards being aware of warning signs and medical help seeking, awareness regarding passive detection behavior, and intention to be aware of possible warning signs and to timely seek medical help. Further, the campaign was evaluated on recall and recognition and the various campaign components were evaluated with respect to interest, credibility, comprehensibility, informative value, and personal relevance.

Section snippets

Respondents and procedure

The effects of the campaign were tested in a longitudinal study using a Solomon four-group design and data was collected by means of computer assisted telephone interviews. A sample of 1074 Dutch adults of 55 years and older was derived from the Dutch Telecommunication Company (KPN Telecom) in October 2004. In order to approach as many adults of 55 years and older as possible, regions with an above-average number of people within this age group were selected. Preceding the study, respondents

Statistical analyses

Data were analyzed using the ‘Statistical Package for Social Science’ (SPSS version 12.0 for Windows; SPPS, Chicago, IL). Multinominal regression analysis was conducted to test for possible differences in demographics between the four groups. In order to examine the effects of the campaign on the Dutch population of 55+ years, several steps of analyses were conducted. First, differences between people aware and unaware of the campaign were analyzed. Paired t-tests were conducted to see whether

Respondents characteristics

In total, 784 respondents participated in the present study. Fifty-six percent were female and the mean age of the respondents was 68.3 years (SD = 9.1; range 55–94), with 61% being 65 years or older. Almost two-third of the respondents lived together with a partner or spouse. The majority (44%) had a low educational level (primary or basic vocational school), 27% had a medium level of education (secondary vocational school or high school), and 29% were educated at higher vocational school or

Discussion

The present study was conducted to evaluate the impact of a Dutch national campaign on early detection of cancer on knowledge, attitudes, awareness, and the willingness to perform passive detection and timely seeking medical help. The results showed that respondents completing just the post-test measurement had similar levels of attitudes, awareness, and intentions as respondents who have completed both pre-test and post-test questionnaires. There was a borderline significant difference between

Conflict of interest

The authors have no conflict of interest to declare.

Acknowledgement

This study was supported by a grant from the Dutch Cancer Society.

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