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.

Clinical trial registration

ISRCTN16872545.

中文翻译：

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对生活在英国贫困地区的成年人进行有针对性的癌症意识干预的随机对照试验和经济评估

 背景

在社会经济贫困的社区，癌症治疗效果较差，对症状的认识较低，导致长期寻求帮助和晚期疾病。有针对性的癌症意识干预措施需要评估。

 方法

这是一项随机对照试验，参与者是在南约克郡和威尔士东南部贫困地区的社区和医疗机构招募的 40 岁以上成年人。干预：由训练有素的非专业顾问提供个性化的行为建议。控制：常规护理。随机分组后两周和六个月进行随访。主要结果：随机分组后两周的总癌症症状识别评分。

 结果

234 名参与者被随机分组​​。两周时总症状识别的差异[调整平均差 (AMD) 0.6, 95% CI: -0.03, 1.17, p = 0.06] 没有统计学意义。干预参与者报告六个月时症状识别能力提高（AMD 0.8，95% CI：0.18，1.37， p = 0.01），预期表现更早（AMD -2.0，95% CI：-3.02，-0.91， p < 0.001）。干预组对“鲜为人知”的症状识别度较高（2 周 AMD 0.5，95% CI：0.03、0.97；6 个月 AMD 0.7，95% CI：0.16、1.17）。每个参与者的实施成本为 91.34 英镑，干预后医疗资源使用的组间差异不显着。

 结论

在长期随访中，症状识别能力得到改善，预期表现也更早。 ABACus 健康检查是一种可行的低成本干预措施，旨在提高社会经济贫困社区的癌症意识。

临床试验注册

 ISRCTN16872545。