Evidence map›Paper›PMID 41535080›Full record

ArticleBMJ open2026

Randomised controlled community trial assessing efficacy of the AWACAN-ED public toolkit to improve cancer symptom awareness and intention to seek help in South Africa and Zimbabwe: study protocol.

Suzanne Scott, Jone G Lurgain, Sarah Day, Bothwell T Guzha, Ekaterina Pazukhina, Kirsten Deanne Arendse, Sudarshan Govender, Mike Chirenje, Valerie Anne Sills, Jane Harries and 3 more

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Suzanne ScottWolfson Institute of Population Health, Queen Mary University of London, London, UK suzanne.scott@qmul.ac.uk.ORCID http://orcid.org/0000-0001-5536-9612
Jone G LurgainWolfson Institute of Population Health, Queen Mary University of London, London, UK.ORCID http://orcid.org/0000-0003-4265-8268
Sarah DaySchool of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape, South Africa.ORCID http://orcid.org/0000-0003-2165-3580
Bothwell T GuzhaFaculty of Medicine & Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Ekaterina PazukhinaWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Kirsten Deanne ArendseWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Sudarshan GovenderSchool of Public Health, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa.ORCID http://orcid.org/0000-0003-1565-0703
Mike ChirenjeFaculty of Medicine & Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Valerie Anne SillsWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Jane HarriesCancer Association of South Africa, Johannesburg, South Africa.
Rosemary JacobsUMTHA Strategy Planning and Development, Cape Town, South Africa.
Jennifer MoodleySchool of Public Health, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa.
Fiona M WalterWolfson Institute of Population Health, Queen Mary University of London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite the benefits of early diagnosis, most cancers in sub-Saharan African (SSA) countries are diagnosed at an advanced stage due to late presentation of symptoms, inadequate referral systems and poor diagnostic capacity. Health communication interventions have been used extensively in high-income countries to increase people's awareness of cancer symptoms and encourage timely help-seeking. However, in SSA, there is still limited evidence on the effectiveness of these interventions and existing evaluations are mainly focused on communicable diseases rather than cancer. METHODS AND ANALYSIS: A randomised, multisite, controlled community trial will evaluate a culturally tailored health infographic toolkit delivered in rural and urban settings in the Western Cape Province in South Africa and Harare and surrounding provinces in Zimbabwe. Participants will be randomised to receive one of three African aWAreness of CANcer and Early Diagnosis (AWACAN-ED) cancer awareness tools, coproduced with local communities, comprising health communication infographics with descriptions of breast, cervical and colorectal cancer symptoms plus messages to encourage consultation with primary care providers if symptoms occur, all presented in English and four local languages. We will recruit 144 participants in each of the three intervention groups (N=432). The primary outcome will be recall of symptoms and the secondary outcomes will be (1) intention to seek help, (2) emotional impact and (3) acceptability of the toolkit. Outcomes will be measured preintervention and at two points postintervention: after 15 min and 1 month. ETHICS AND DISSEMINATION: Ethical approval was obtained in both participating countries, South Africa (148/2025) and Zimbabwe (363/2021). All participants will be required to provide written informed consent prior to participation. Findings will be disseminated through peer-reviewed publications, conference presentations and the AWACAN-ED programme website. TRIAL REGISTRATION NUMBER: PACTR202505475803308.

Indexed as

Early Detection of CancerHealth CommunicationHealth Knowledge, Attitudes, PracticeNeoplasmsPatient Acceptance of Health CareFemaleHumansMaleMulticenter Studies as TopicRandomized Controlled Trials as TopicSouth AfricaZimbabweAfrica South of the SaharaAwarenessEarly Detection of CancerHealth EducationPrimary Health CareRandomized Controlled Trial

Identifiers

PMID41535080
PMCPMC12815121

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.