Executive summary

Be Clear on Cancer (BCOC) is a program of activity launched by Public Health England (PHE) in 2010, with the aim of improving England's cancer survival rates by raising awareness of the signs and symptoms of cancer, encouraging those with symptoms to see their doctor as soon as possible, and promoting the benefits of early diagnosis.

After 10 years of activity, PHE decided to sense-check its approach and look for areas of optimisation.

PHE commissioned cultural strategy agency Flamingo to unearth barriers to early presentation and find ways of overcoming them with future campaigns and communications. Flamingo used a combination of linguistic modelling and semiotic analysis to identify and explore both the "public" and "personal" discourses of cancer and the ways in which they interact, and revealed two key insights: the first is that the journey up until the point of diagnosis is less well represented and consequently, less well understood by the majority of the public than the post-diagnosis journey. The other key insight was that many of the most common ways in which cancer is represented are in stark opposition to one another, meaning that cancer is often represented and understood as a series of extremes.