Oesophago-gastric cancers campaign: Overview

The term 'oesophago-gastric' (OG) refers to cancers of the oesophagus (ICD10 code C15) and stomach (ICD10 code C16).

Advertising ran across England from 26 January to 22 February 2015.

The key message promoted on TV will be: ‘Having heartburn, most days, for 3 weeks or more could be a sign of cancer – tell your doctor.’

A second message, promoted via other campaign materials, will be: ‘Food sticking when you swallow could be a sign of cancer – tell your doctor.’

Results from a regional (Feb - Mar 2014) and seven local oesophago-gastric cancers pilot campaigns (Apr-Jul 2012), have shown promising results therefore Public Health England and their partners would like to roll the campaign out nationally at the next opportunity. However, it is acknowledged that heartburn is a common complaint therefore measures are being taken to help limit the impact of the campaign on local services. For example, advertising (including TV and radio) will only run for 4 weeks, rather than the usual 6 weeks.

View evaluation findings

Download NHS tripartite letter (campaign announcement)

Based on a review of current evidence and the advice of a panel of experts, including clinicians and patient group representatives, these two symptoms were identified to hold a strong association with earlier stage ‘OG’ cancers. Examples of the supporting evidence for these key messages include:

• A strong association has long been identified between heartburn/regurgitation symptoms and oesophageal cancer.

• Data from the Northern Oesophago-gastric Unit indicates that 38% of patients with heartburn/indigestion (dyspepsia) but no dysphagia (food sticking upon swallowing) referred between January 2008 and January 2013 had early stage oesophageal cancer (stage 1-2) [1].  

• An investigation into varying gastroscopy referral rates among GP practices supports the use of gastroscopy to investigate persistent heartburn (dyspepsia). The study found patients belonging to GP practices with the lowest gastroscopy rates were at greater risk of a poor outcome.

• The campaign also focuses on food sticking upon swallowing (dysphagia), which, along with the symptom of dyspepsia, features in NICE referral guidelines for suspected cancer. The guidelines recommend all patients presenting with dysphagia should be placed on an urgent referral.

References

1. Northern Oesophago-gastric Unit (NOGU). The Oesophago-Gastric Cancer Awareness Campaign – The Importance of Heartburn in Improving Patient Outcomes. Newcastle upon Tyne: NOGU; 2013

Men and women over the age of 50 from lower socioeconomic groups, and their key influencers, such as friends and family.

By targeting this age group, Public Health England and the Department of Health aim to focus the campaign on those with the greatest risk of developing the disease.

The key risk factor for both oesophageal and stomach cancers is increasing age, with more than 95% of oesophago-gastric cancers diagnosed in people aged 50 or over in England [1]. It is also more common among men (particularly white British men), than women [1]. Almost twice as men, than women are diagnosed with OG cancers each year [1]. Other risk factors [2] include:

• Smoking – is the biggest lifestyle risk factor for both oesophageal and stomach cancers, accounting for nearly 7 out of 10 cases of oesophageal cancer and nearly 1 out of 5 cases of stomach cancer
• Alcohol – around 2 in 10 cases of oesophageal cancer are linked to consuming alcohol on a regular basis
• Being overweight or obese is linked to around 2 in 10 cases of oesophageal cancer
• Barrett’s oesophagus: chronic and severe reflux can lead to Barrett’s oesophagus and, in a small number of cases, can develop into oesophageal cancer.
• Diet: approximately 1 in 5 cases of stomach cancer are associated with a consuming too much salt (more than 6g per day on a regular basis)
• Heliobacter pylori (H pylori) infections are linked to nearly 1 in 3 cases of stomach cancer
• Radiotherapy – A small number of cases of oesophageal cancers (around 3 in 100 cases) and stomach cancers (1 in 100 cases) can be attributed to previous exposure to radiation for medical reasons (e.g. radiotherapy for previous cancers)

References

1. Incidence data supplied by West Midlands KIT based on NCRS data

2. Parkin DM, Boyd L, Walker LC (2011) The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. British Journal of Cancer. 105, S77-S81.

Each year in England, nearly 6,900 people are diagnosed with oesophageal cancer and around 6,200 die from it; around 6,000 people are diagnosed with stomach cancer and over 4,000 die from the disease [1]

In the UK, survival outcomes for oesophageal cancer (adenocarcinoma) among men are the worst in the world

Oesophago-gastric cancers are the 4th and 5th most common type of cancer death in males & females respectively [1]

Over the past 17 years, the numbers of adenocarcinoma oesophageal cancers diagnosed have increased by an average of 3.9% per year from 2,000 cases in 1995 to 3,800 cases in 2012 [1]

When diagnosed at the earliest stage, one-year survival for oesophago-gastric cancers is as high as 75 - 87%. At late stage, it is as low as 20-21% [2]

It is estimated that nearly 950 deaths from oesophago-gastric cancers could be avoided each year if five-year survival rates matched the best in Europe.

References

1. Incidence data supplied by West Midlands KIT based on NCRS data

2. Deaths data supplied by West Midlands KIT based on ONS data

A range of Be Clear on Cancer materials were developed for the regional oesophago-gastric cancer campaign, including a leaflet, x2 versions of poster and symptom cards. These items are available to download now however all materials will be reviewed and updated where necessary prior to the launch of the national campaign in January 2015. Check back in January for updated materials.

Download campaign materials from the Tools and resources page.

Order printed materials online or call 0300 123 1002