2) What are the national tumour specific cancer charities doing wrong in awareness raising?

Cancer charities are wedded to too much detail.

There is some agreement on of what basic cancer awareness content should consist, but single issue charities complicate this by persisting in finessing with their own details, in order to draw attention to their ‘special’ case. As the Cancer Awareness Measure study (mentioned in 1) measures confusion and uncertainty, it is time the site specific voluntary sector acknowledged they will be generating some of it through their activities.
 
The detail on display in a cancer charity’s awareness agenda makes sense to them as experts in their own cancer but it overwhelms the audience. As all cancer charities approach the detail of awareness in similar fashion the consequences are predictable. Men and women have to remember – or whatever it is that they are expected to do with the lists of symptoms - at least 79 symptoms if they are to be considered aware, by standard cancer charity convention, of each of the top ten cancers with which they are most likely to be diagnosed.
 
Cancer charity are muddled about the audience
 
National tumour specific cancer charities are so concerned about their respective USPs they have not wondered if their respective cancer awareness raising adds up to a coherent picture across the sector. Most of whom they consider ‘their’ audience are shared with many other single issue cancer charities – and then there are all the other health charities for heart, stroke, diabetes and the rest. Individuals in the general public are exposed to a large number of cancer awareness messages over and over again, about each tumour and all the other health issues too. Women, who don’t know as much about non gender-specific cancers (bowel, lung etc) as they should, are now also regarded as legitimate targets for messages about men’s cancers too. No wonder everyone loses track, forgets, misses some and ultimately, perhaps, ignores them. Women need more information than they realise and some men are being given permission not to bother with some of their's.
 
As national single issue cancer charities campaign, educate and inform on one cancer site they never mention any others. From the point of view of an unaffected individual as yet unaware when, or if, or which cancer diagnosis may emerge in their life, this is both mad and maddening. Single issue cancer charities have no concept of their health promotion that fits it within the context of other health issues. National single issue cancer charities do not have the income or connections to engage large scale with populations particularly beset by cancer – those with socio-economic or other inequalities - where the largest gains are needed to make cancer health promotion really effective. Some of these populations overlap with the ‘hard to reach’ groups – who, as the name implies may ignore, never get, fail to recognise, are never targeted with, misunderstand, reject or otherwise be separated from most health messaging.
 
Cancer charities muddle ‘cause’ with ‘corporate’
 
'Awareness' is not conceived of primarily as a service to the public, but also as a service to the charity. Site specific charities muddle awareness raising for public good and elide it with concern about their share of media coverage, donor recruitment and retention, income generation and as a device to increase corporate profile and brand awareness.
 
They can also dilute information about the cancer by taking the chance to inject a line or two to enhance their corporate profile. Flabby corporate rhetoric about ‘leading charity’, ‘dealing only with’, ‘established since’ is wearisome and will crop up.   
 
Cancer charities muddle media coverage with evidence of effectiveness
 
Broadcast and press media coverage is clearly an important device for awareness raising. However, media prejudice warps the end result. Cancer charity PR is so bound up with appeasing media tastes that gender specific cancers have the highest profile, adversely affecting lung and bowel cancer profile which, though common, are not conventionally engaging. The taste for novelty in news also means the unusually young ‘sufferer’ and unusually rare cancer get coverage, which again excludes bowel and lung cancers from the profile. This is a challenge for organisations working in that area. The youth obsessed media are indulged in their prejudice by the type of case studies they are prepared to accept  from charities, who know this and play along. As a result older men and women, who are at the highest risk of cancer, rarely appear anywhere in cancer charity generated media coverage.
 
Cancer charities focus on the wrong thing and the wrong audience
 
The voluntary sector model of cancer awareness is wrongly directed. Their cancer is the unit of interest to them, when it should be the people who need to know the message.
 
The current audience for cancer awareness raising by tumour specific charities is not primarily the unaffected general public. Many cancer charities are thinking of the affected supporters and users they already have. Awareness raising is a major opportunity to demonstrate that the charity understands affected supporters’ feelings, is engaged, enthusiastic, committed and dedicated and is respecting their user voice and experience.
 
Awareness raising in cancer charities is sentimental, not rational. It gives a voice to people with a deep personal link to the cause who can talk with emotional weight. The charities take their personal stories and reflect them outwards but without useful context for the audience. This is difficult for the public to assimilate as they have no way of knowing how this relates to them or how it fits in with any other major health issue they may experience.  Beyond the narrow detail of their special cancer, the site specific charities have no concept of the person with whom they are trying to communicate. They act as if they think they are only ever talking to a potential sufferer of their cancer. There is also a tendency to think of ‘awareness’ from the perspective of what they want to say (and also what the fundraising opportunities are) and not what the audience may need to hear.
 
The chance for affirmation and validation of personal experience that drives much awareness raising is an ineffective way to inform the much larger, as yet unaffected, audience who need something more objective. This may be the one case where user involvement in cancer charity work is a problem rather than a solution.  
 
Affected supporters act as drivers and arbiters of much of the awareness agenda. They will often be the younger and more active individuals, attracted to awareness campaigning and ‘putting something back’ by a personal collision with the issue, which also tends to insert a class bias. A third of new cancers are diagnosed in men and women aged over 75 and these men and women may miss, ignore or not internalise imagery or messaging that features younger people. The 'voice' of peole with a cancer diagnosis creates an emotional overlay and urgency to act, or be ‘empowered’ or join the ‘cause’ which might actually make things worse, by putting off some of the audience who are merely after facts, or who are one of the 37% of people in the CAM study who are so anxious about cancer that they would delay a GP visit for fear of ‘what the doctor might say’.
 
Breast cancer charities already acknowledge they have used younger women so frequently in marketing that post-menopausal women are unaware they are at greatest risk of getting breast cancer. The ovarian cancer charities have not noticed this at all and are striding off on the same misguided route by using younger women (Emilia Fox last year, Gaby Roslin this) to raise awareness of ovarian cancer. Ovarian cancer is predominantly a disease of older women, with the highest incidence in women aged 65 and over. The average age of men diagnosed with prostate cancer is about 72 and of men dying from prostate cancer, around 80. Men aged more than 60 do not feature in high profile awareness raising from the prostate cancer charities.Media coverage, youth obsession and cancer awareness are not a good fit for most cancers but single issue cancer charities will not stop cooperating with it any time soon.
 
If the single issue cancer charities are getting it wrong, what could they do to put it right?