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Be Clear on Cancer Oesophageal and stomach cancers PR Toolkit February 2014

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Content Page Number

1. Executive summary Page 3

2. Campaign overview Page 4

Launch PR Page 4

Roadshow Page 4

Activity for disabled people Page 4

3. Key messages Page 6

4. Facts & stats Page 7

5. Resources Page 8

Case studies Page 8

Templates Page 9

Campaign materials Page 10

6. Social media Page 11

Twitter Page 11

Facebook Page 12

Social media advice Page 13

7. Appendix 1 –Incidence and mortality data Page 14

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1. Executive summary Public Health England is piloting an oesophageal and stomach cancers symptom awareness campaign in the North East and North Cumbria under the Be Clear on Cancer banner. Run in partnership with the Department of Health and NHS England, the campaign launches on 10 February. It aims to raise public awareness of the possible symptoms of oesophageal and stomach cancers, and encourage those with symptoms to visit their GP. The oesophagus (more commonly known as the gullet or food pipe) is the long tube that carries food from the throat to the stomach. The campaign includes two symptom messages. The key message is: Heartburn most days for 3 weeks or more could be a sign of cancer - tell your doctor The second message is: Food sticking when you swallow could be a sign of cancer - tell your doctor This toolkit has been developed primarily to help PHE regional comms leads in the area promote the campaign. It includes advice, information and templates to help ensure campaign messages are consistent across all channels, from local media to promotion by partners. While all campaign materials and content in this toolkit are under strict embargo until 00:01 on 10 February 2014, this toolkit can be shared with colleagues in local authorities and NHS regional teams, to enable them to promote the campaign via their channels too – please reinforce this embargo when sharing any materials Checklist of activity PHE regional comms leads, supported by freuds (PHE‟s campaigns PR agency), will promote the launch of this Be Clear on Cancer regional campaign. Post Monday 10 February, there are a number of activities and opportunities that the regional team and Be Clear on Cancer supporters can carry out in support of the campaign, including:

Use the short or long copy templates below to help draft articles about the campaign for newsletters, websites or social media networks

Feature campaign key messages and facts and stats in any relevant communications about the campaign

Plan and co-ordinate your own communications activity, referring to the resource section of this document for guidance

Utilise available social media networks, e.g. Facebook and Twitter, to provide regular updates and information on the campaign, to help maintain momentum

Please note that this campaign is embargoed until 00:01 hours 10 February 2014

Good luck with your activities and thank you in advance for all your help.

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2. Campaign overview Be Clear on Cancer – oesophageal and stomach cancer symptom awareness campaign The Government‟s priorities for cancer as set out in Improving Outcomes: A Strategy for Cancer (January 2011) includes the ambition to save an additional 5,000 lives per year by 2014/2015. To support this ambition, one of the key actions is to raise public awareness of the symptoms of cancer and encourage earlier presentation to primary care. Following a successful local pilot in 2012, the Be Clear on Cancer oesophageal and stomach cancer campaign is being rolled out at a regional level, encouraging people in the North East and North Cumbria to see their doctor if they notice possible symptoms, particularly “heartburn most days for three weeks or more” or “food sticking when you swallow”. Early diagnosis of these cancers makes them more treatable, so encouraging people to see their doctor sooner could save their life. The campaign is aimed at men and women from lower socioeconomic groups over 50 – those most at risk of developing oesophageal or stomach cancer – and their key influencers such as family and friends. Around 12,600 people are diagnosed with oesophageal or stomach cancer each year in England and around 12,200 (more than 95%) are over 501. These diseases cause around 10,100 deaths in England each year2. Early diagnosis is crucial – around three quarters (73-88%) of all people diagnosed with the earliest stage oesophageal cancer survive their disease for at least one year. This figure is less than a quarter (16-22%) for those diagnosed with the most advanced stage of the disease3. In 2009 it was estimated that around 950 lives could be saved in England each year if our survival rates for oesophageal and stomach cancers matched the best in Europe4. The campaign will run for four weeks, from 10 February to 9 March, across the North East and North Cumbria (the Borders and North East television regions). Adverts will appear on TV, radio and in the press. A direct mail letter and leaflet will be sent to around 100,000 people in the target audience and there will be events at sports venues such as football grounds. Launch PR Freuds will lead in the development of media materials ahead of the launch. PHE regional comms leads should email the freuds team if they have any queries, on BeClearonCancer@freuds.com. Activity for disabled people Disabled people make up a proportion of the target audience of the campaign and are known to have worse health outcomes than the general population. Fact-finding found people with sensory impairments and learning disabilities are more likely to be excluded from the mainstream communications and have problems spotting the symptoms of cancer.

1 Number of cases of oesophageal and stomach cancer (ICD-10: C15 and C16) in England in 2011 (for age groups, the annual average number of cases

between 2009 and 2011 is given). Reference: Data were provided by the Office for National Statistics on request, July 2013. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html 2 Number of deaths from oesophageal and stomach cancer (ICD-10: C15 and C16) in England in 2011. Reference: Data were provided by the Office for

National Statistics on request, March 2013. Similar data can be found here: http://www.ons.gov.uk/ons/publications/all-releases.html?definition=tcm%3A77-27475 3 One year relative survival rates for patients diagnosed with oesophageal cancer (ICD-10: C15) between 2004 and 2008 in the former East of England

Cancer Network. Reference: 2008 Survival, Recent cancer outcomes in the East of England, Eastern Cancer Registry and Information Centre (ECRIC),

http://ecric.nhs.uk/2008-survival 4 British Journal of Cancer (2009) 101, S115–S124. doi:10.1038/sj.bjc.6605401. Published online 3 December 2009. Access via:

http://www.nature.com/bjc/journal/v101/n2s/full/6605401a.html

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Steps have been made to ensure the campaign communications are as accessible as possible and the mainstream leaflet has been produced in alternative formats, including Braille, audio, large print, BSL and easy read. These are available online and as hard copies. Engagement is also taking place with disability organisations to raise awareness of the symptoms of cancer amongst these audiences in the North West, communicate bespoke messages and raise awareness of the availability of the alternative formats. For more information about the alternative formats and engagement with disability groups contact barry@bdscommunications.co.uk or phone 07808 707288.

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3. Key messages The key campaign messages below will be communicated and shared throughout the campaign – please refer to this list when drafting any communication materials. We‟ve referred to “cancer” rather than “oesophageal and stomach cancer” in the TV, radio and print advertising as many people don‟t know what the oesophagus is. If you do wish to refer to these specific types of cancer, please explain that the oesophagus is the long tube that carries food from the throat to the stomach and is commonly known as the gullet or foodpipe.

Primary message Heartburn most days for three weeks or more could be a sign of cancer – tell your doctor. The chances are it‟s nothing serious, but finding it early makes it more treatable

Secondary

message Food sticking when you swallow could be a sign of

cancer – tell your doctor. It might not be anything serious, but if there is something wrong, then finding it early makes it more treatable

Key messages

around

symptoms

See your doctor if you‟ve had heartburn most days for three weeks or more. Even if you‟re taking medicine and it seems to help, you still need to see your doctor

Heartburn most days for three weeks or more could be a sign of oesophageal or stomach cancer

Other symptoms of oesophageal or stomach cancer may include:

o food sticking when you swallow o indigestion on and off for three weeks or more o losing weight for no obvious reason o trapped wind and frequent burping o feeling full very quickly when eating o feeling bloated after eating o nausea or vomiting o stomach pain

Key messages

around raising

awareness that

early diagnosis

improves

survival chances

Early diagnosis and treatment for cancer can save lives

Spotting cancer early can make a real difference – treatment is more likely to be successful

Key messages

around

sanctioning the

trip to doctor

You are not wasting anyone‟s time by getting your symptoms checked out – if it isn‟t serious, your mind will be put at rest

But if it is cancer, early detection makes it easier to treat so seeing your doctor early could save your life

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4. Facts, statistics and further information

Around 12,600 people are diagnosed with oesophageal or stomach cancer in England each

year1

Oesophageal and stomach cancers affect both men and women but are more common in men:

Every year in England around 6,900 people (4,700 men and 2,200 women) are diagnosed

with oesophageal cancer5 Every year in England around 5,700 people (3,700 men and 2,000 women) are diagnosed

with stomach cancer6

Around 95% of people diagnosed with oesophageal and stomach cancer are aged 50 or over1

Around 10,100 people die from oesophageal or stomach cancer in England each year7:

o Every year in England around 6,200 people (4,200 men and 2,000 women) die from

oesophageal cancer8 o Every year in England around 3,900 people (2,450 men and 1,450 women) die from

stomach cancer9

Not enough people are diagnosed early with oesophageal and stomach cancers. To help improve survival rates it is important to raise awareness of the symptoms and encourage people to visit their doctor if they experience any of them

42% of oesophageal patients survive for at least one year after diagnosis; however five year survival is 14%10

5 Number of cases of oesophageal cancer (ICD-10: C15) and stomach cancer (ICD-10: C16) in England in 2011 (for age groups, the annual average

number of cases between 2009 and 2011 is given). Reference: Data were provided by the Office for National Statistics on request, July 2013. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html 6 Number of cases of stomach cancer (ICD-10: C16) in England in 2011 (for age groups, the annual average number of cases between 2009 and 2011 is

given). Reference: Data were provided by the Office for National Statistics on request, July 2013. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html 7 Number of deaths from oesophageal and stomach cancers (ICD-10: C15 and C16) in England in 2011. Reference: Data were provided by the Office for

National Statistics on request, March 2013. Similar data can be found here: http://www.ons.gov.uk/ons/publications/all-releases.html?definition=tcm%3A77-27475 8 Number of deaths from oesophageal cancer (ICD-10: C15) and stomach cancer (ICD-10: C16) in England in 2011. Reference: Data were provided by the

Office for National Statistics on request, March 2013. Similar data can be found here: http://www.ons.gov.uk/ons/publications/all-releases.html?definition=tcm%3A77-27475 9 Number of deaths from stomach cancer (ICD-10: C16) in England in 2011. Reference: Data were provided by the Office for National Statistics on request, March 2013. Similar data can be found here: http://www.ons.gov.uk/ons/publications/all-releases.html?definition=tcm%3A77-27475 10 Age-standardised net survival rates for oesophageal cancer (ICD-10: C15) patients diagnosed in England 2007-2011. Reference: Office for National Statistics. Cancer survival rates, Cancer Survival in England: Patients Diagnosed 2007-2011 and Followed up to 2012; ONS; 2013.

Your doctor is aware of the key signs of cancer. They are ready and waiting to help, and will not think you are wasting their time

Your family and friends care about you – if they suggest you go to the doctor, you should listen

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43% of stomach cancer patients survive for at least one year after diagnosis; however, five year survival is 19%11

In 2009 it was estimated that around 950 deaths from oesophageal and stomach cancers could

be avoided in England each year if survival rates matched the best in Europe4

This Be Clear on Cancer campaign aims to raise awareness of oesophageal and stomach

cancer symptoms and to encourage people with any symptoms to go and see their GP

All of the GPs featured in the Be Clear on Cancer adverts are practising GPs. The call to action in all the campaigns is to “tell your doctor” if you have any of the given symptoms

This campaign is the latest in a number of Be Clear on Cancer awareness campaigns. To date there have been three Be Clear on Cancer campaigns at a national level – bowel cancer, lung cancer and “blood in pee” (a symptom of bladder and kidney cancers) and we are currently running a national campaign on breast cancer aimed at women aged over 70, until mid-March. There has also been a range of campaign pilots at a regional and local level. They have all been aimed at those most likely to develop cancer

5. Resources Case studies If you are aware of any case studies you may wish to include them in your promotional activities to help bring the campaign to life. Case studies are an important element to a health campaign as they add the human dimension needed to help raise awareness of the campaign issues and can help encourage conversations about particular topics. They also offer opportunities for greater in-depth coverage and discussion about campaign subjects. While you might not come across many/any patients in your role, you may wish to get in touch with NHS comms leads in your region, or clinical commissioning groups, to help source case studies. The ideal case study would meet the following criteria:

Diagnosed with oesophageal or stomach cancer at 50 years of age or over

Visited their doctor after noticing one of the key possible symptoms - heartburn most days for three weeks or more, or food sticking when swallowed

Received treatment on the NHS, and had a good experience with their care

Has been treated successfully and made a good recovery

Happy to speak to media and have their story published/broadcast and preferably happy to speak to media too

11 Age-standardised net survival rates for stomach cancer (ICD-10: C16) patients diagnosed in England 2007-2011. Reference: Office for National

Statistics. Cancer survival rates, Cancer Survival in England: Patients Diagnosed 2007-2011 and Followed up to 2012; ONS; 2013.

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If you do find any case studies, below are some questions and key pieces of information to ask. If you need any more support or advice on this, please email the Be Clear on Cancer team at BeClearOnCancer@freuds.com or call 020 3003 6587/ 020 3003 6319. Name, age and location What were the first symptoms and when were they first noticed? When did they go to their doctor? What happened next (screening / tests)? What treatment followed the diagnosis? How did they feel about the diagnosis? How important is/was it to get an early diagnosis? How do they feel after the (successful) operation/treatment? Did their friends or family play a part in encouraging them to visit their GP? What do they particularly value in their life (now they have recovered)? Do they have children/grandchildren? A head and shoulders high resolution photograph If the case studies agree to be interviewed by journalists, make sure you identify which types of media they are happy speaking with (i.e. they may not want to do radio interviews, but will talk to a regional print journalist). Also, make sure they are aware of the campaign key messages and that they are comfortable with them. It is also important to ensure a consent form is signed by all case studies, and any copy written about them, that is kept on file, is approved before being shared with media. Again, freuds can guide and support you on this area. Templates Please find below some examples of copy that you could use when communicating with your audiences about the Be Clear on Cancer oesophageal and stomach cancer regional campaign. This copy can be used across a range of channels, for example, websites, e-bulletins, newsletters, or for social media purposes. Simply cut and paste this copy, add the relevant local information and share. Short Copy – for email, bulletins and websites New pilot campaign urges: Be alert to the symptoms of cancer <Insert organisation/group name> is supporting the new Be Clear on Cancer campaign. The campaign will run from 10 February to 9 March 2014 in the North East and North Cumbria with the aim of raising awareness of possible symptoms of oesophageal cancer (cancer of the gullet/foodpipe) and stomach cancer. The campaign urges people to tell their doctor if they‟ve had heartburn most days for three weeks or more, or if food is sticking when they swallow. Around 12,600 people are diagnosed with oesophageal or stomach cancer in England each year and these cancers cause around 10,100 deaths annually. This needn‟t be the case - knowing what to look out for could save lives. For further information about the signs and symptoms of oesophageal and stomach cancers, please visit nhs.uk/ogcancer

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Long copy – for more in-depth publications including newsletters New pilot campaign urges: Be alert to the symptoms of cancer <Insert organisation/group name> is supporting new Be Clear on Cancer campaign. The campaign will run from 10 February to 9 March 2014 in the North East and North Cumbria with the aim of raising awareness of possible symptoms of oesophageal cancer (cancer of the gullet/foodpipe) and stomach cancer. The campaign urges people to tell their doctor if they‟ve had heartburn most days for three weeks or more, or if food is sticking when they swallow. Other symptoms of oesophageal or stomach cancer may include:

o losing weight for no obvious reason o trapped wind and frequent burping o feeling full very quickly when eating o feeling bloated after eating o nausea or vomiting o stomach pain

Around 12,600 people are diagnosed with oesophageal or stomach cancer in England each year and these cancers cause around 10,100 deaths annually. This needn‟t be the case - knowing what to look out for could save lives. For further information about the signs and symptoms of oesophageal and stomach cancers, please visit nhs.uk/ogancer Campaign Materials Leaflets and posters are available to order and we would ask local teams to help distribute to libraries, community settings, local charities, pharmacies, Citizens Advice Bureaux and any other suitable venues. These can be ordered free of charge from www.orderline.dh.gov.uk or telephone: 0300 123 1002 using the following product codes:

2901445 OESOPHAGEAL CANCER LEAFLET A5

2901768 OESOPHAGEAL CANCER A4 POSTER MALE GP

2901769 OESOPHAGEAL CANCER A4 POSTER FEMALE GP

2901770 OESOPHAGEAL CANCER A3 POSTER MALE GP

2901771 OESOPHAGEAL CANCER A3 POSTER FEMALE GP

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6. Social media

From Monday 10 February, following the campaign launch, please use your online channels to talk

about the campaign and raise awareness of the importance of early diagnosis of cancer.

We have included some suggested tweets and Facebook posts about the campaign below to support the campaign: Twitter

Suggested/sample Tweets

A new Be Clear on Cancer campaign is being piloted in the N East & N Cumbria. For more info visit nhs.uk/ogcancer #beclearoncancer

Do you know what oesophageal cancer is? Find out – visit nhs.uk/ogcancer #OGcancer #beclearoncancer

Early diagnosis of oesophageal and stomach cancers can save lives. Visit nhs.uk/ogcancer #OGcancer #beclearoncancer

Heartburn most days for 3 weeks or more? Tell your doctor #OGcancer. Visit nhs.uk/ogcancer #beclearoncancer

Support the new @PHE_uk campaign in N East & N Cumbria #beclearoncancer #OGcancer. Visit nhs.uk/ogcancer

Around 6,900 people in England are diagnosed with oesophageal cancer each year. Early diagnosis can save lives #OGcancer

Around 5,700 people in England are diagnosed with stomach cancer each year. Early diagnosis can save lives #OGcancer

People over 50 years old are more at risk of oesophageal and stomach cancers. Visit nhs.uk/ogcancer for info #OGcancer

Visit your doctor if you‟ve had heartburn most days for 3 weeks or more. #OGcancer nhs.uk/ogcancer #beclearoncancer

For information on the signs of oesophageal and stomach cancers visit nhs.uk/OGcancer #OGcancer #beclearoncancer

Help save lives in the N East & N Cumbria - know the signs of oesophageal and stomach cancers. Visit nhs.uk/ogcancer #OGcancer

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Facebook

Post

Public Health England is piloting a Be Clear on Cancer campaign in the North East and North Cumbria to raise awareness of possible signs and symptoms of oesophageal and stomach cancers - particularly persistent heartburn. If you have heartburn most days for three weeks or more, tell your doctor. There are around 12,600 new cases of oesophageal and stomach cancer in England each year. These diseases cause around 10,100 deaths annually, but this needn‟t be the case.

Early diagnosis of cancer makes it more treatable, so visit your doctor if you are experiencing any of the symptoms. Visit nhs.uk/ogcancer for further information.

Please support the new Be Clear on Cancer symptom awareness campaign and post this as your status if you know someone with oesophageal or stomach cancer: If you‟ve had heartburn most days for 3 weeks or more, tell your doctor. It could be a sign of oesophageal or stomach cancer. Finding it early makes it more treatable and could save your life. Other possible symptoms of these types of cancer include:

• Indigestion on and off for 3 weeks or more • Food feels like it‟s sticking in your throat when you swallow • Losing weight for no obvious reason • Trapped wind and frequent burping • Feeling full very quickly when eating • Feeling bloated after eating • Nausea or vomiting • Stomach pain

Find out more about the signs and symptoms of oesophageal and stomach cancers at nhs.uk/ogcancer

If you‟ve had heartburn most days for 3 weeks or more, tell your doctor. It‟s probably nothing serious but could be a sign of something else that needs treatment. See your doctor to be on the safe side.

Visit nhs.uk/ogcancer for more information.

You can also support and follow the Be Clear on Cancer, oesophageal and stomach cancers campaign in the North East and North Cumbria on Twitter. Please help increase awareness by re-tweeting messages. Don‟t forget to use the #OGcancer hashtags.

If oesophageal or stomach cancer is detected early, it is more treatable. Finding it early could save your life. Heartburn most days for 3 weeks or more could be a sign. See your doctor if you are worried. Visit nhs.uk/ogcancer for more information on the signs and symptoms of oesophageal and stomach cancers.

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Social media advice

Please follow @beclearoncancer and re-tweet messages where relevant

Use the #OGcancer hashtag in tweets where possible and encourage people to use the same – this will help the topic to „trend‟ and appear on more feeds

Engage with people who reply to your tweets/posts with questions or comments to continue momentum.

If you are unsure of the answer to a question from someone on Twitter or Facebook, contact the Be Clear on Cancer team at freuds (BeClearonCancer@freuds.com)

Interact with relevant partners and follow their Twitter feeds – eg local media outlets, local cancer support groups and NGOs, local MPs and local authorities in and around your area. Ask them to re-tweet messages and build a relationship with them

As well as encouraging your followers and local organisations/contacts to re-tweet your messages, it‟s important to ensure you do the same and re-tweet relevant and interesting messages

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7. Appendix 1: Regional oesophageal and stomach cancer data Data provided by Public Health England, West Midlands Knowledge & Intelligence Team, extracted from the Cancer Analysis System, December 2013 The following tables show a) the number of oesophageal cancer cases and deaths registered in 2011 and b) the number of stomach cancer cases and deaths registered in 2011 Oesophageal cancer:

Cases registered Deaths registered

Geography name Males Females Persons Males Females Persons

North East 243 100 343 209 98 307

Gateshead 20 7 27 26 6 32

Newcastle upon Tyne 20 11 31 18 6 24

North Tyneside 11 4 15 14 5 19

South Tyneside 11 2 13 10 5 15

Sunderland 23 12 35 21 6 27

Hartlepool 11 1 12 12 3 15

Middlesbrough 13 10 23 9 8 17

Redcar and Cleveland 17 10 27 14 6 20

Stockton-on-Tees 22 5 27 19 9 28

Darlington 10 6 16 8 8 16

County Durham 57 15 72 36 19 55

Northumberland 28 17 45 22 17 39

Cumbria 57 26 83 50 23 73

Stomach cancer:

Cases registered Deaths registered

Geography name Males Females Persons Males Females Persons

North East 272 132 404 189 104 293

Gateshead 24 11 35 22 6 28

Newcastle upon Tyne 28 20 48 20 10 30

North Tyneside 24 11 35 11 5 16

South Tyneside 17 5 22 8 4 12

Sunderland 25 15 40 23 14 37

Hartlepool 7 5 12 6 5 11

Middlesbrough 7 7 14 12 4 16

Redcar and Cleveland 14 6 20 11 7 18

Stockton-on-Tees 22 10 32 5 8 13

Darlington 11 4 15 8 4 12

County Durham 64 25 89 41 27 68

Northumberland 29 13 42 22 10 32

Cumbria 42 30 72 31 21 52

The tables above provide data for North East PHE Centre and Cumbria: The Be Clear on Cancer oesophageal and stomach cancers campaign is based on the North East and Borders TV areas and so covers the North East and North Cumbria.

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