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

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.

Prevalence of cancer alarm symptoms: a population-based cross-sectional study.

OBJECTIVE: To estimate the prevalence of alarm symptoms for breast, colorectal, urinary tract, and lung cancer in the general population. DESIGN: Cross-sectional questionnaire survey. SETTING: The former County of Funen, Denmark, with 480,000 inhabitants. PARTICIPANTS: A total of 13,777 randomly selected persons aged 20 years and older. MAIN OUTCOME MEASURES: Prevalence estimates of having experienced cancer alarm symptoms during the past 12 months: a lump in the breast, blood in bowel movements, blood in urine, or coughing for more than six weeks. The number of alarm symptoms experienced within the past 12 months was also calculated. RESULTS: With a response rate of 69%, 3.3% of responders (95% CI 2.9% to 3.7%) reported a lump in their breast, 5.7% (5.2% to 6.3%) reported blood in bowel movements, 2.2% (1.9% to 2.5%) reported blood in urine, and 6.5% (6.1% to 7.5%) reported coughing for more than six weeks within the past 12 months. Overall, 15.3% (95% confidence interval 14.3% to 16.3%) of the females and 12.7% (11.6% to 13.7%) of the males reported having experienced at least one cancer alarm symptom within the past 12 months. CONCLUSION: Alarm symptoms of breast, colorectal, urinary tract, and lung cancer are common in the general population and approximately 15% of the population have experienced at least one of these cancer alarm symptom within the past 12 months.

[Cognitive functions and driving ability of older drivers]. / Kognitive funktioner og kørefaerdighed hos aeldre bilister.

INTRODUCTION: The aim of the study was to test older drivers applying for a renewal of their driver's license for cognitive impairment and to examine the outcome of a subsequent driving test. MATERIAL AND METHODS: Patients registered with general practitioners (GPs) in the County of Southern Jutland, who applied for a renewal of their driver's license because of age, participated in the study. Data were collected from a questionnaire sent to GPs and from driving license certificates. The test used m-mini mental state (m-MMSE) for registration of cognitive functioning was a short version of MMSE. The number of recommended driving tests and the results of the driving test were compared during a period before and after the test was used, and compared with the result of the m-MMSE. A total of 6,091 elderly participated in the study, 2,631 before and 3,460 after the introduction of the test. In addition a semi-structured telephone interview with a random sample of the participating GPs was carried out. RESULTS: The use of m-MMSE resulted in significantly more older drivers being recommended a driving test and significantly fewer having their driver's license renewed. Of the older drivers who were recommended a driving test and did not have their driver's license renewed, 83% and 60% had impaired cognitive functioning. The majority (95%) of the GPs considered the test to be a useful tool in general practice. DISCUSSION: The results show that the use of m-MMSE when older drivers apply for renewal of their driver's license because of age, led to fewer older drivers having their driver's license renewed, and that most of them have impaired cognitive functioning. The test is suitable for general practice.

Lower urinary tract symptoms (LUTS) and sexual function in both sexes.

OBJECTIVES: It has been stated that lower urinary tract symptoms (LUTS) do not affect sexual function to any significant degree, but a recent study has suggested that there might be an association in men. The present study was conducted to investigate the relationship between LUTS and sexual problems in both men and women aged 40-65 years. METHODS: The survey was conducted in Denmark between May and June 2003. Detailed questionnaires were mailed to a random sample of 15,000 men and women aged 40-65 years. LUTS and sexual function were assessed by validated symptom scales. Multivariate regression analysis was performed using logistic regression for dichotomous dependent variables of sexual function. The independent variables for both sexes were age, LUTS, partner status, body mass index (BMI), alcohol consumption and co-morbidities. RESULTS: A total of 15,000 questionnaires were mailed out, 8491 were completed and returned, and 7741 were deemed valuable and included in the analysis. LUTS and sexual dysfunction were common in both men and women. Logistic regression analysis of items related to erection problems and satisfaction with sex life in men and sexual function in women showed that LUTS are an independent risk factor for sexual dysfunction in both men and women aged 40-65 years. Significant effects on sexual function were also found for the independent variables of partner status and co-morbidities. CONCLUSIONS: The presence of LUTS is an independent risk factor for sexual dysfunction in men and women. These results highlight the clinical importance of evaluating LUTS in patients with sexual dysfunction, and the need to consider sexual issues in the management of patients with LUTS.