Skip to main content
Top
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Associations between reporting of cancer alarm symptoms and socioeconomic and demographic determinants: a population-based, cross-sectional study

Authors: Rikke Pilsgaard Svendsen, Maja Skov Paulsen, Pia Veldt Larsen, Bjarne Lühr Hansen, Henrik Støvring, Dorte Ejg Jarbøl, Jens Søndergaard

Published in: BMC Public Health | Issue 1/2012

Login to get access

Abstract

Background

Reporting of symptoms which may signal cancer is the first step in the diagnostic pathway of cancer diseases. Cancer alarm symptoms are common in the general population. Public awareness and knowledge of cancer symptoms are sparse, however, and many people do not seek medical help when having possible cancer symptoms. As social inequality is associated with cancer knowledge, cancer awareness, and information-seeking, our hypothesis is that social inequality may also exist in the general population with respect to reporting of cancer alarm symptoms. The aim of this study was to investigate possible associations between socioeconomic and demographic determinants and reporting of common cancer alarm symptoms.

Methods

A cross-sectional questionnaire survey was performed based on a stratified sample of the Danish general population. A total of 13 777 randomly selected persons aged 20 years and older participated. Our main outcome measures were weighted prevalence estimates of self-reporting one of the following cancer alarm symptoms during the preceding 12 months: a lump in the breast, coughing for more than 6 weeks, seen blood in urine, or seen blood in stool. Logistic regression models were used to calculate unadjusted and adjusted odds ratios with 95% confidence intervals for the associations between each covariate and reporting of cancer alarm symptoms.

Results

A total of 2 098 (15.7%) of the participants reported one or more cancer alarm symptoms within the preceding 12 months.
Women, subjects out of the workforce, and subjects with a cancer diagnosis had statistically significantly higher odds of reporting one or more cancer alarm symptoms. Subjects with older age and subjects living with a partner had lower odds of reporting one or more cancer alarm symptoms. When analysing the four alarm symptoms of cancer separately most tendencies persisted.

Conclusions

Socioeconomic and demographic determinants are associated with self-reporting of common cancer alarm symptoms.
Appendix
Available only for authorised users
Literature
1.
go back to reference The Danish National board of health: The Danish National board of health. 2005, - Denmark: National cancer Plan II, 9-12-2009. Ref Type: Report The Danish National board of health: The Danish National board of health. 2005, - Denmark: National cancer Plan II, 9-12-2009. Ref Type: Report
2.
go back to reference Fijten GH, Blijham GH, Knottnerus JA: Occurrence and clinical significance of overt blood loss per rectum in the general population and in medical practice. Br J Gen Pract. 1994, 44: 320-325.PubMedPubMedCentral Fijten GH, Blijham GH, Knottnerus JA: Occurrence and clinical significance of overt blood loss per rectum in the general population and in medical practice. Br J Gen Pract. 1994, 44: 320-325.PubMedPubMedCentral
3.
go back to reference Svendsen RP, Stovring H, Hansen BL, Kragstrup J, Sondergaard J, Jarbol DE: Prevalence of cancer alarm symptoms: a population-based cross-sectional study. Scand J Prim Health Care. 2010, 28: 132-137. 10.3109/02813432.2010.505412.CrossRefPubMedPubMedCentral Svendsen RP, Stovring H, Hansen BL, Kragstrup J, Sondergaard J, Jarbol DE: Prevalence of cancer alarm symptoms: a population-based cross-sectional study. Scand J Prim Health Care. 2010, 28: 132-137. 10.3109/02813432.2010.505412.CrossRefPubMedPubMedCentral
4.
go back to reference Eslick GD, Kalantar JS, Talley NJ: Rectal bleeding: epidemiology, associated risk factors, and health care seeking behaviour: a population-based study. Colorectal Dis. 2009, 11: 921-926. 10.1111/j.1463-1318.2008.01721.x.CrossRefPubMed Eslick GD, Kalantar JS, Talley NJ: Rectal bleeding: epidemiology, associated risk factors, and health care seeking behaviour: a population-based study. Colorectal Dis. 2009, 11: 921-926. 10.1111/j.1463-1318.2008.01721.x.CrossRefPubMed
5.
go back to reference Simon AE, Waller J, Robb K, Wardle J: Patient delay in presentation of possible cancer symptoms: the contribution of knowledge and attitudes in a population sample from the United kingdom. Cancer Epidemiol Biomarkers Prev. 2010, 19: 2272-2277. 10.1158/1055-9965.EPI-10-0219.CrossRefPubMedPubMedCentral Simon AE, Waller J, Robb K, Wardle J: Patient delay in presentation of possible cancer symptoms: the contribution of knowledge and attitudes in a population sample from the United kingdom. Cancer Epidemiol Biomarkers Prev. 2010, 19: 2272-2277. 10.1158/1055-9965.EPI-10-0219.CrossRefPubMedPubMedCentral
6.
go back to reference Hamilton W, Sharp D: Diagnosis of colorectal cancer in primary care: the evidence base for guidelines. Fam Pract. 2004, 21: 99-106. 10.1093/fampra/cmh121.CrossRefPubMed Hamilton W, Sharp D: Diagnosis of colorectal cancer in primary care: the evidence base for guidelines. Fam Pract. 2004, 21: 99-106. 10.1093/fampra/cmh121.CrossRefPubMed
7.
go back to reference Power E, Simon A, Juszczyk D, Hiom S, Wardle J: Assessing awareness of colorectal cancer symptoms: Measure development and results from a population survey in the UK. BMC Cancer. 2011, 11: 366-10.1186/1471-2407-11-366.CrossRefPubMedPubMedCentral Power E, Simon A, Juszczyk D, Hiom S, Wardle J: Assessing awareness of colorectal cancer symptoms: Measure development and results from a population survey in the UK. BMC Cancer. 2011, 11: 366-10.1186/1471-2407-11-366.CrossRefPubMedPubMedCentral
8.
go back to reference Yardley C, Glover C, len-Mersh TG: Demographic factors associated with knowledge of colorectal cancer symptoms in a UK population-based survey. Ann R Coll Surg Engl. 2000, 82: 205-209.PubMedPubMedCentral Yardley C, Glover C, len-Mersh TG: Demographic factors associated with knowledge of colorectal cancer symptoms in a UK population-based survey. Ann R Coll Surg Engl. 2000, 82: 205-209.PubMedPubMedCentral
9.
go back to reference Berkman L, Epstein AM: Beyond health care–socioeconomic status and health. N Engl J Med. 2008, 358: 2509-2510. 10.1056/NEJMe0802773.CrossRefPubMed Berkman L, Epstein AM: Beyond health care–socioeconomic status and health. N Engl J Med. 2008, 358: 2509-2510. 10.1056/NEJMe0802773.CrossRefPubMed
10.
go back to reference Protiere C, Moumjid N, Bouhnik AD, Le Corroller Soriano AG, Moatti JP: Heterogeneity of Cancer Patient Information-Seeking Behaviors. Med Decis Making. 2012, 32 (2): 362-75. 10.1177/0272989X11415114. Epub 2011 Aug 24CrossRefPubMed Protiere C, Moumjid N, Bouhnik AD, Le Corroller Soriano AG, Moatti JP: Heterogeneity of Cancer Patient Information-Seeking Behaviors. Med Decis Making. 2012, 32 (2): 362-75. 10.1177/0272989X11415114. Epub 2011 Aug 24CrossRefPubMed
11.
go back to reference Dalton SO, Schuz J, Engholm G, Johansen C, Kjaer SK, Steding-Jessen M, et al: Social inequality in incidence of and survival from cancer in a population-based study in Denmark, 1994–2003: Summary of findings. Eur J Cancer. 2008, 44: 2074-2085. 10.1016/j.ejca.2008.06.018.CrossRefPubMed Dalton SO, Schuz J, Engholm G, Johansen C, Kjaer SK, Steding-Jessen M, et al: Social inequality in incidence of and survival from cancer in a population-based study in Denmark, 1994–2003: Summary of findings. Eur J Cancer. 2008, 44: 2074-2085. 10.1016/j.ejca.2008.06.018.CrossRefPubMed
12.
go back to reference Statistics Denmark: StatBank Denmark. 2009, 8-12. Ref Type: Online Source Statistics Denmark: StatBank Denmark. 2009, 8-12. Ref Type: Online Source
13.
go back to reference Frank L: Epidemiology, When an entire country is a cohort. Science. 2000, 287: 2398-2399. 10.1126/science.287.5462.2398.CrossRefPubMed Frank L: Epidemiology, When an entire country is a cohort. Science. 2000, 287: 2398-2399. 10.1126/science.287.5462.2398.CrossRefPubMed
14.
go back to reference The Danish National board of health. 2009, Copenhagen: Cancerregisteret 2007, Ref Type: Report The Danish National board of health. 2009, Copenhagen: Cancerregisteret 2007, Ref Type: Report
15.
go back to reference Jones R, Latinovic R, Charlton J, Gulliford MC: Alarm symptoms in early diagnosis of cancer in primary care: cohort study using General Practice Research Database. BMJ. 2007, 334: 1040-10.1136/bmj.39171.637106.AE.CrossRefPubMedPubMedCentral Jones R, Latinovic R, Charlton J, Gulliford MC: Alarm symptoms in early diagnosis of cancer in primary care: cohort study using General Practice Research Database. BMJ. 2007, 334: 1040-10.1136/bmj.39171.637106.AE.CrossRefPubMedPubMedCentral
16.
go back to reference Salzman BE, Lamb K, Olszewski RF, Tully A, Studdiford J: Diagnosing cancer in the symptomatic patient. Prim Care. 2009, 36: 651-670. 10.1016/j.pop.2009.07.005.CrossRefPubMed Salzman BE, Lamb K, Olszewski RF, Tully A, Studdiford J: Diagnosing cancer in the symptomatic patient. Prim Care. 2009, 36: 651-670. 10.1016/j.pop.2009.07.005.CrossRefPubMed
17.
go back to reference Barton MB, Elmore JG, Fletcher SW: Breast symptoms among women enrolled in a health maintenance organization: frequency, evaluation, and outcome. Ann Intern Med. 1999, 130: 651-657.CrossRefPubMed Barton MB, Elmore JG, Fletcher SW: Breast symptoms among women enrolled in a health maintenance organization: frequency, evaluation, and outcome. Ann Intern Med. 1999, 130: 651-657.CrossRefPubMed
18.
go back to reference Beckles MA, Spiro SG, Colice GL, Rudd RM: Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes. Chest. 2003, 123: 97S-104S. 10.1378/chest.123.1_suppl.97S.CrossRefPubMed Beckles MA, Spiro SG, Colice GL, Rudd RM: Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes. Chest. 2003, 123: 97S-104S. 10.1378/chest.123.1_suppl.97S.CrossRefPubMed
19.
go back to reference Statistics Denmark. Statistics Denmark. 2011, Ref Type: Online Source Statistics Denmark. Statistics Denmark. 2011, Ref Type: Online Source
20.
go back to reference Rasmussen JN, Rasmussen S, Gislason GH, Buch P, Abildstrom SZ, Kober L, et al: Mortality after acute myocardial infarction according to income and education. J Epidemiol Community Health. 2006, 60: 351-356. 10.1136/jech.200X.040972.CrossRefPubMedPubMedCentral Rasmussen JN, Rasmussen S, Gislason GH, Buch P, Abildstrom SZ, Kober L, et al: Mortality after acute myocardial infarction according to income and education. J Epidemiol Community Health. 2006, 60: 351-356. 10.1136/jech.200X.040972.CrossRefPubMedPubMedCentral
21.
go back to reference Rasmussen JN, Rasmussen S, Gislason GH, Abildstrom SZ, Schramm TK, Torp-Pedersen C, et al: Persistent socio-economic differences in revascularization after acute myocardial infarction despite a universal health care system-a Danish study. Cardiovasc Drugs Ther. 2007, 21: 449-457. 10.1007/s10557-007-6058-7.CrossRefPubMed Rasmussen JN, Rasmussen S, Gislason GH, Abildstrom SZ, Schramm TK, Torp-Pedersen C, et al: Persistent socio-economic differences in revascularization after acute myocardial infarction despite a universal health care system-a Danish study. Cardiovasc Drugs Ther. 2007, 21: 449-457. 10.1007/s10557-007-6058-7.CrossRefPubMed
22.
go back to reference Rasmussen JN, Gislason GH, Rasmussen S, Abildstrom SZ, Schramm TK, Kober L, et al: Use of statins and beta-blockers after acute myocardial infarction according to income and education. J Epidemiol Community Health. 2007, 61: 1091-1097. 10.1136/jech.2006.055525.CrossRefPubMedPubMedCentral Rasmussen JN, Gislason GH, Rasmussen S, Abildstrom SZ, Schramm TK, Kober L, et al: Use of statins and beta-blockers after acute myocardial infarction according to income and education. J Epidemiol Community Health. 2007, 61: 1091-1097. 10.1136/jech.2006.055525.CrossRefPubMedPubMedCentral
23.
go back to reference Paulsen MS, Andersen M, Munck AP, Larsen PV, Hansen DG, Jacobsen IA, et al: Socio-economic status influences blood pressure control despite equal access to care. Fam Pract. 2012, Epub ahead of print Paulsen MS, Andersen M, Munck AP, Larsen PV, Hansen DG, Jacobsen IA, et al: Socio-economic status influences blood pressure control despite equal access to care. Fam Pract. 2012, Epub ahead of print
24.
go back to reference Dalton SO, Steding-Jessen M, Gislum M, Frederiksen K, Engholm G, Schuz J: Social inequality and incidence of and survival from cancer in a population-based study in Denmark, 1994–2003: Background, aims, material and methods. Eur J Cancer. 2008, 44: 1938-1949. 10.1016/j.ejca.2008.06.010.CrossRefPubMed Dalton SO, Steding-Jessen M, Gislum M, Frederiksen K, Engholm G, Schuz J: Social inequality and incidence of and survival from cancer in a population-based study in Denmark, 1994–2003: Background, aims, material and methods. Eur J Cancer. 2008, 44: 1938-1949. 10.1016/j.ejca.2008.06.010.CrossRefPubMed
25.
go back to reference Simon AE, Juszczyk D, Smyth N, Power E, Hiom S, Peake MD, et al: Knowledge of lung cancer symptoms and risk factors in the U.K.: development of a measure and results from a population-based survey. Thorax. 2012, 67: 426-432. 10.1136/thoraxjnl-2011-200898.CrossRefPubMed Simon AE, Juszczyk D, Smyth N, Power E, Hiom S, Peake MD, et al: Knowledge of lung cancer symptoms and risk factors in the U.K.: development of a measure and results from a population-based survey. Thorax. 2012, 67: 426-432. 10.1136/thoraxjnl-2011-200898.CrossRefPubMed
26.
go back to reference Low EL, Simon AE, Lyons J, Romney-Alexander D, Waller J: What do British women know about cervical cancer symptoms and risk factors?. Eur J Cancer. 2012, Epub ahead of print Low EL, Simon AE, Lyons J, Romney-Alexander D, Waller J: What do British women know about cervical cancer symptoms and risk factors?. Eur J Cancer. 2012, Epub ahead of print
28.
go back to reference Kroenke K, Price RK: Symptoms in the community. Prevalence, classification, and psychiatric comorbidity. Arch Intern Med. 1993, 153: 2474-2480. 10.1001/archinte.1993.00410210102011.CrossRefPubMed Kroenke K, Price RK: Symptoms in the community. Prevalence, classification, and psychiatric comorbidity. Arch Intern Med. 1993, 153: 2474-2480. 10.1001/archinte.1993.00410210102011.CrossRefPubMed
29.
go back to reference Krantz G, Ostergren PO: Common symptoms in middle aged women: their relation to employment status, psychosocial work conditions and social support in a Swedish setting. J Epidemiol Community Health. 2000, 54: 192-199. 10.1136/jech.54.3.192.CrossRefPubMedPubMedCentral Krantz G, Ostergren PO: Common symptoms in middle aged women: their relation to employment status, psychosocial work conditions and social support in a Swedish setting. J Epidemiol Community Health. 2000, 54: 192-199. 10.1136/jech.54.3.192.CrossRefPubMedPubMedCentral
30.
go back to reference McAteer A, Elliott AM, Hannaford PC: Ascertaining the size of the symptom iceberg in a UK-wide community-based survey. Br J Gen Pract. 2011, 61: e1-e11. 10.3399/bjgp11X548910.CrossRefPubMed McAteer A, Elliott AM, Hannaford PC: Ascertaining the size of the symptom iceberg in a UK-wide community-based survey. Br J Gen Pract. 2011, 61: e1-e11. 10.3399/bjgp11X548910.CrossRefPubMed
31.
go back to reference van Wijk CM, Kolk AM: Sex differences in physical symptoms: the contribution of symptom perception theory. Soc Sci Med. 1997, 45: 231-246. 10.1016/S0277-9536(96)00340-1.CrossRefPubMed van Wijk CM, Kolk AM: Sex differences in physical symptoms: the contribution of symptom perception theory. Soc Sci Med. 1997, 45: 231-246. 10.1016/S0277-9536(96)00340-1.CrossRefPubMed
33.
go back to reference Hickey T: Self-care behavior of older adults. Family & Community Health: The Journal of Health Promotion & Maintenance. 1988, 11 (3): 23-32.CrossRef Hickey T: Self-care behavior of older adults. Family & Community Health: The Journal of Health Promotion & Maintenance. 1988, 11 (3): 23-32.CrossRef
34.
go back to reference Smith SM, Campbell NC, Macleod U, Lee AJ, Raja A, Wyke S, et al: Factors contributing to the time taken to consult with symptoms of lung cancer: a cross-sectional study. Thorax. 2009, 64: 523-531. 10.1136/thx.2008.096560.CrossRefPubMed Smith SM, Campbell NC, Macleod U, Lee AJ, Raja A, Wyke S, et al: Factors contributing to the time taken to consult with symptoms of lung cancer: a cross-sectional study. Thorax. 2009, 64: 523-531. 10.1136/thx.2008.096560.CrossRefPubMed
35.
go back to reference James WP, Nelson M, Ralph A, Leather S: Socioeconomic determinants of health. The contribution of nutrition to inequalities in health. BMJ. 1997, 314: 1545-1549. 10.1136/bmj.314.7093.1545.CrossRefPubMedPubMedCentral James WP, Nelson M, Ralph A, Leather S: Socioeconomic determinants of health. The contribution of nutrition to inequalities in health. BMJ. 1997, 314: 1545-1549. 10.1136/bmj.314.7093.1545.CrossRefPubMedPubMedCentral
36.
Metadata
Title
Associations between reporting of cancer alarm symptoms and socioeconomic and demographic determinants: a population-based, cross-sectional study
Authors
Rikke Pilsgaard Svendsen
Maja Skov Paulsen
Pia Veldt Larsen
Bjarne Lühr Hansen
Henrik Støvring
Dorte Ejg Jarbøl
Jens Søndergaard
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-686

Other articles of this Issue 1/2012

BMC Public Health 1/2012 Go to the issue