Find Cancer Early
Our campaign aimed at reducing the disparity in cancer survival between regional and metropolitan Western Australians, Find Cancer Early, has been running since 2011. Great progress has been made so far, but there is still work to be done.
People living in regional Australia have lower rates of five year survival for all cancers combined, compared with people living in major cities. This gap is due to several factors, including but not limited to: disparities in access to diagnostic and treatment services, delays in primary care investigation referrals, and characteristics of rural Western Australians that may result in delayed help-seeking behaviour. All these factors can prolong time to diagnosis, which is a critical determinant of individual survival outcome.
The Find Cancer Early campaigns aim to reduce the disparity in cancer survival between people in regional Western Australia (WA) and people in the Perth metropolitan area. The campaigns are targeted specifically at regional Western Australians aged over 40 years. The Find Cancer Early campaigns also target Aboriginal and Torres Strait Islander peoples, who experience disproportionately higher rates of cancer incidence and mortality compared with non-Aboriginal Australians.
The Find Cancer Early campaigns aim to:
- Increase campaign awareness.
- Increase awareness of the symptoms of the five most common cancer types (prostate, breast, skin, bowel, and lung).
- Decrease the time between discovering symptoms and taking help-seeking action.
- Close the gap in cancer survival between rural and metropolitan Western Australians.
The Find Cancer Early program was developed by Cancer Council WA in 2011 as part of the Improving Rural Cancer Outcomes Partnership Project with the WA Department of Health and The University of Western Australia. It began as a randomised control trial (excluding television as a media channel) in a few select regions of WA.
The current campaign, funded by the WA Department of Health's Cancer and Palliative Care Network targets all of regional WA through local staff disseminating information, as well as mass media. Due to budget limitations, Find Cancer Early has broadcast just one television advertisement over the last few years.
The 'Rural Doctors Bathroom' advertisement features five real regional general practitioners encouraging Western Australians to look for cancer symptoms and discuss any unusual body changes with a general practitioner. This advertisement was then adapted to digital advertising formats for Facebook, YouTube and Gmail advertising platforms.
To complement the television and online campaign, a suite of radio advertisements was created featuring Aboriginal and non-Aboriginal male and female talent. A symptom checklist was also widely distributed to regional people, including a checklist designed specifically for Aboriginal audiences.
Personal testimonies housed on the program website and utilised in paid and unpaid social media have also proven to expand the reach of the Find Cancer Early messages. Not only does the inclusion of local champions ensure regional people feel the messages are relevant, but champions continue to disseminate the campaign messages throughout their local networks.
Key performance indicators are measured by Computer-Assisted Telephone Interview Surveys conducted after each campaign wave (n=1934 in 2018; n=1051 in 2019; and n=1052 in 2020). Survey respondents are regional Western Australians aged over 40 years, with equal representation across gender and specific regions. Across the three campaign waves from 2018 to 2020, over two-thirds of participants were aged from 41 to 64 years, with the remainder aged 65 years or older.
Increased campaign awareness
Total prompted and unprompted campaign awareness increased from 67 per cent in 2018 to 76 per cent in 2019, and then 77 per cent in 2020.1
Among respondents who recalled the Find Cancer Early campaign, recall of three or more symptoms increased from 24 per cent in 2018 to 26 per cent in 2019, and then dropped to 16.8 per cent in 20201. The Find Cancer Early target is to increase awareness of three or more symptoms to 35 per cent.
In previous campaigns, advertisements referred to multiple symptoms; for example, the television advertisement listed five symptoms and the checklist listed 10 different symptoms. It is possible that the large array of symptoms described in campaigns may affect recall, and therefore future campaign advertisements will feature fewer cancer symptoms.
Decreased time between discovering symptom and seeking help
Of those respondents who recalled the campaign, the percentage who sought some form of help within one month of seeing the campaign increased from 11 per cent in 2018 to 32 per cent in 2019, and then to 61 per cent in 20201. Seeking help included the following: making an appointment with a general practitioner, monitoring symptoms, or speaking to a family member or friend about symptoms.
Access to primary health services in regional and remote areas
People living in regional and remote WA generally have poorer access to primary health services than people living in metropolitan areas. In WA, very remote areas have less than half the number of general practitioners per person compared with major cities.
Characteristics of regional Western Australians
A 2009 study assessing symptom appraisal and help-seeking intervals of regional Western Australian cancer patients identified optimism, stoicism and machismo as core characteristics contributing to delayed diagnosis.
Cultural approaches to cancer
A community report on Aboriginal people's beliefs about and experiences of cancer described several factors that might influence decisions to seek medical help after noticing symptoms, including fatalism, feelings of shame, and fear of having to leave family, community and country for treatment.
Other barriers to reducing time to diagnosis
Whilst the Find Cancer Early campaign aims to reduce the time it takes for regional Western Australians to seek help if they have symptoms, there are many other factors in Western Australia that also affect time to diagnosis, such as delays in investigation, referrals and appointments.
Volume and complexity of campaign messaging
Educating Western Australians about the five most common cancers presents a challenge for Find Cancer Early campaigns, as there are a considerable number of symptoms to promote. While the program focuses on ten symptoms, each of these requires medical attention with varying levels of urgency, which adds another layer of complexity to campaign messaging and comprehension by target audiences.
A Find Cancer Early symptom checklist displays the ten priority symptoms.
Funding and campaign longevity
In 2017, Cancer Council WA secured $1.6 million dollars over four years to continue and expand the delivery of Find Cancer Early in regional WA. Although this investment has enabled progress toward campaign objectives, a larger and more sustained investment is required to address other barriers (listed above) and to improve cancer survival among regional and rural Western Australians.
The next phase of the Find Cancer Early campaign will expand the promotion of champion stories. Following the success of this strategy on social media and the program website, powerful personal testimonies will be utilised for future television commercials and complementary materials. This next phase and following phases will also feature a smaller list of symptoms than previous campaigns, as it is hoped this will assist with symptom recall.
Closing the rural-metropolitan cancer survival gap
An improvement in survival is not only limited to symptom awareness and help-seeking behaviour; it would also benefit from a reduction in the delays in investigations, referrals, appointments, and treatment. Although addressing these factors is not currently within the remit of the Find Cancer Early campaign, a comprehensive health promotion campaign would ideally use multiple strategies to influence them as well. As the Find Cancer Early campaign grows and barriers in the pathway to treatment and survival are identified, further strategies and multi-level approaches will be added to the campaign.
Securing ongoing program funding poses a challenge for Find Cancer Early, as the program's funding resulted from a State election commitment that is scheduled to end in July 2022. Now more than ever, the campaign needs continued funding to implement a comprehensive campaign with multiple strategies and levels, to improve the poorer cancer outcomes for regional Western Australians.
- Pantaleo, A., Haywood, D., Grant, H., Alexander, E., Lawrence, B., & O'Connor, M. (2020). Find Cancer Early Evaluation Data: Results, Tables and Figures. WA Cancer Prevention Research Unit (WACPRU), Curtin University, Perth.
- Visit the Find Cancer Early website