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Promoting breast cancer awareness in older women during the seasonal flu vaccination campaign

10 January 2019
Volume 28 · Issue 1



older women are at high risk of presenting with breast cancer when it has reached a late stage, which may be partly because of poor breast cancer awareness.


the aim of this project was to implement and evaluate a new way of delivering the Promoting Early Presentation (PEP) Intervention during flu vaccination appointments in primary care. The PEP Intervention is a 1–minute intervention, accompanied by a booklet and delivered by primary care health professionals to provide older women with the knowledge, confidence and skills to present promptly on discovering symptoms of breast cancer.


health professionals delivered the PEP Intervention to older women at six general practices in south London. The authors measured changes in breast cancer awareness after the intervention and interviewed practice staff about their experiences of using it.


knowledge of breast symptoms and breast checking was greater in women aged 70 years and above after the implementation than before. Health professionals' found it acceptable and feasible to implement.


this intervention is a novel way of increasing breast cancer awareness in older women, which could contribute to earlier presentation and diagnosis of breast cancer in the UK.

Almost half of all breast cancers are diagnosed in women aged over 65 years and, when older women are diagnosed, their cancers are more likely to be at a more advanced stage than those in younger women in the UK (Lyratzopoulos et al, 2012; Cancer Research UK, 2016). Low awareness of breast cancer symptoms, particularly non-lump symptoms, and the increasing risk of breast cancer with age can mean that women are less likely to check their breasts, leading to a higher probability of delayed presentation (Ramirez et al, 1999; Linsell et al, 2008; Koo et al, 2017).

The authors developed the Promoting Early Presentation (PEP) Intervention, a scripted one-to-one interaction between a health professional and a woman, which is supported by an information booklet for the woman to take home. The PEP Intervention targets older women's knowledge, motivation, confidence and skills to present promptly with breast cancer symptoms (Burgess et al, 2008; 2009).

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