Promoting Awareness of Cancer and Early Detection (PACED) Initiative in Malaysia The incidence of cancer in Malaysia and cancer-related deaths are increasing. The relatively high cancer mortality rate accounted for 10% of medically certified deaths. Age-standardized incidence rates for all cancers were 137 and 156 per 100,000 in males and females, respectively.  Cancer-related may be avoided by early presentation, detection and appropriate treatment. However, cancers in Malaysia present at late stages. Research indicates clearly that there is a low level of cancer awareness in Malaysia and that low awareness delays help seeking, late presentation is high and detection rates are poor. More recently, our research group conducted a nationally representative survey of 1817 adults and found  anticipated delay  and several emotional barriers to seeking help. In addition, there were strong misbeliefs about cancer. For example, more than 30% did not belive that cancer could be cured and worryingly, 65% thought that most cancer treatments were worse than cancer itself.   In order to support earlier presentation and diagnosis and improve survival rates, the "Be Clear on Cancer" (BCOC) programme was launched in England in 2011 and, more recently in 2014, the "Be Cancer Aware Programme" (BeCAP) was designed and implemented by Northern Ireland's Public Health Agency. Evaluation findings reported an increased awareness about the signs and symptoms of cancer as well as increased attendance at GP practices by patients who reported key campaign-related symptoms. In addition, more people were referred urgently by GPs for suspected cancer, there  was an increase in diagnostic investigation activity and there was a shift towards earlier stage disease. There is a clear need for a co-ordinated, large scale population-based cancer awareness raising programme in Malaysia. Our population-based surveys indicate that particular attention should be paid to targeting common cancer disparities among various ethnic, socio-economic and geographical groups in Malaysia.  The main aim of the proposed project is to address the need to design and develop a programme or intervention that is theoretically informed, evidence-based and culturally appropriate for Malaysia and then to evaluate robustly the programme by building upon the BCOC and BeCAP programmes.  The project comprises four phases. Phase 1 - 'Development of a culturally sensitive cancer Awareness Raising Programme (CARP)' - the main aim of this phase is to develop the content of the CARP including the key messages and design and test mode(s) of delivery. The CARP will focus on the three most prevalent cancers in Malaysia - lung, breast and colorectal. Phase 2 - 'Design the evaluation framework', - a workshop will be held to discuss and finalise the evaluation framework and metrics particularly regarding the identification of the outcomes of the CARP and the assessment tools in the context of the Malaysian infrastructure and health system. The evaluation framework will be informed by the approach and methods used in the appraisal of the BeCAP and it will include a population awareness survey before-and-after the implementation of each BeCAP campaign in order to ascertain changes in awareness including recognition, attitudes, beliefs and knowledge about cancer and early diagnosis. Phase 3, 'Undertaking formative research' - qualitative and quantitative methods will be used to test the appropriateness, acceptability and feasibility of the CARP and assessment tools. Phase 4, 'Evaluate the impact of the CARP' - a large scale pilot evaluation study will be conducted in the Federal Territory of Kuala Lumpur and Selangor state. Pre-and post-campaign surveys will be carried out to evaluate the performance of campaign in term of awareness of signs and symptoms, beliefs and attitudes towards cancer and early diagnosis and attendance at primary care physicians with the symptoms highlighted in the campaign. Finally, we will develop a protocol for the roll-out of a national level CARP. The Newton Fund builds research and innovation partnerships with developing countries across the world to promote the economic development and social welfare of the partner countries.