Programme no. 334-OP
Public Health
Barriers towards contact to general practice when experiencing alarm symptoms of colorectal cancer in the Danish population
Dorte Ejg Jarbøl*1, Rikke Pilsgaard Svendsen2, Maja Petersen3, Sanne Rasmussen4, Ahmad Mojib Fallah5, Sandra Elnegaard6
1Research Unit of General Practice,Department of Public Health, University of Southern Denmark,Odense,Denmark, 2Research Unit of General Practice,Department of Public Health, University of Southern Denmark,Odense,Denmark, 3University of Southern Denmark,Odense,Denmark, 4Research Unit of General Practice,Department of Public Health, University of Southern Denmark,Odense,Denmark, 5University of Southern Denmark,Odense,Denmark, 6Research Unit of General Practice,Department of Public Health, University of Southern Denmark,Odense,Denmark
* = Presenting author
Objectives: To analyse associations between the experience of alarm symptom of colorectal cancer and four different barriers towards GP contact.
Background: Colorectal cancer is a common cause of death worldwide and Danish cancer patients are often diagnosed with late-stage cancer disease. A prerequisite for general practitioners (GPs) being able to refer patients for further investigations is that people present to the GP with the symptoms. Knowledge about barriers towards help-seeking is, however, sparse.
Results: A total of 49 706 subjects completed the questionnaire. The proportion of subjects with no contact to the GP with alarm symptoms varied between 65.1% and 83.4% for rectal bleeding and change in stool texture, respectively. Some 25.5% reported being too busy to contact the GP with rectal bleeding, and 21.0% were worried about what the doctor might find. The most widely endorsed barriers towards GP contacts were being worried about wasting the doctor’s time and being too busy to make time to visit the doctor. In three out of the four symptoms women significantly more often than men reported being worried about wasting the doctor’s time. Opposite, men significantly more often reported being too busy to contact the GP. The proportion of people reporting barriers towards GP contacts was significantly higher among people in the youngest age group for three of the barriers. This was not the case for ‘Being worried about what the doctor might find, where people with higher ages were more likely to report the barrier.
Material/Methods: A nationwide web-based cohort survey including 100 000 individuals aged 20+ years, randomly selected from the Danish Civil Registration System. Items regarding experience of four predefined alarm symptoms indicative of colorectal cancer (abdominal pain, change in stool texture, change in stool frequency and rectal bleeding) and barriers towards GP contact were included. Barriers towards GP contact explored were ‘I would be too embarrassed', ‘I would be worried about wasting the doctor’s time’, 'I would be worried about what the doctor might find’, and ‘I would be too busy to make time to go to the doctor’.
Conclusion: Barriers towards contact to the GP were frequent when experiencing alarm symptoms of colorectal cancer. Reporting the different barriers was significantly associated with gender and age.
Points for discussion: How can this knowledge of the barriers towards help-seeking be used in future health planning programmes?