Table 3 Studies examining the effectiveness of community-level interventions on early presentation outcomes

Catalano et al (2003)

Breast

Interrupted time-series analysis

22 annual public education broadcast and print media campaigns in three US cities (Atlanta, Detroit and San Francisco) about nature, detection and treatment of breast cancer (Breast Cancer Awareness Month) over 1975–97.

All cancer registrations in Atlanta, Detroit, San Francisco over 23 years

Additional in situ and local breast cancers

790 additional cancers over 23 years (P<0.05)

Gabram et al (2008)

Breast

Before-and-after study

Educational presentations delivered to groups (mainly African-American) by community health advocates in churches, workplaces, schools, etc, in one US city (Atlanta) to reduce breast cancer stage at presentation, during 2001–2004.

Women diagnosed with breast cancer (89% African-American) in one Atlanta hospital in 2001 (n=113) and 2004 (n=128)

Proportion with stage 0

Proportion with stage IV

Increased (12% vs 26%, P<0.005)

Reduced (17% vs 9%, P<0.05)

MacKie et al (2003)

Melanoma

Before-and-after study

Public education campaign in West of Scotland to encourage early presentation in melanoma, delivered by posters and leaflets during 1986–1988.

Scottish people diagnosed with melanoma in one Glasgow clinic in 1986 (n=125) and 2001 (n=162)

Proportion delaying presentation after symptom discovery three or fewer months

Increased (16% vs 67%, 95% confidence interval for difference 42% to 61%)

Proportion with tumour thickness <1.5 mm

Increased (38% vs 72%, 95% confidence interval for difference 23% to 45%)

Rossi et al (2000)

Melanoma

Before-and-after study

Public education campaign in Padua, Italy with broadcast and print media campaign followed by leaflet about symptoms and risk factors for melanoma and skin self-examination, inviting adults to request skin check, delivered by post to every family in Padua over 1991–6.

Padua residents diagnosed with melanoma between 1987–1990 (n=79) and 1991–1996 (n=137)

Mean tumour thickness

Reduced (2.0 mm vs 1.5 mm, P<0.02)

Geczi et al (2001)

Testicular

Before-and-after study

National Hungarian public education campaign about risk factors, importance of early detection and self-examination in testicular cancer, delivered by broadcast and print media and at events over 1995–1998.

Hungarian men diagnosed with testicular cancer in 1994 (n=230) and 1998 (n=214)

Time from symptom discovery to diagnosis

No change

Leander et al (2007)

Retinoblastoma

Before-and-after study

National Honduran public education campaign to increase awareness of early signs of retinoblastoma and to encourage early presentation, delivered by flyers, posters, broadcast and print media and seminars during 2003–2005.

Honduran children diagnosed with retinoblastoma in 1995–2003 (n=59) and 2003–2005 (n=23)

Proportion presenting with advanced disease

Time from symptom discovery to diagnosis

Reduced (73% vs 35%, P=0.002)

No change