title: Alarm symptoms of upper gastrointestinal cancer and contact to general practice--A population-based study.
abstract: BACKGROUND
  Survival of upper gastrointestinal (GI) cancer depends on early stage diagnosis. Symptom-based guidelines and fast-track referral systems have been implemented for use in general practice. To improve diagnosis of upper GI cancer, knowledge on prevalence of alarm symptoms in the general population and subsequent healthcare-seeking is needed.
  
  
  METHODS
  A nationwide study of 100,000 adults, who were randomly selected from the general population were invited to participate in an internet-based survey. People aged ≥45 years were included in this study. Items regarding experience of specific and nonspecific alarm symptoms of upper GI cancer within the preceding 4 weeks and contact to general practitioner (GP) were included.
  
  
  RESULTS
  Of the 60,562 subjects aged ≥45 years, 33,040 (54.6%) completed the questionnaire. The prevalence of the specific alarm symptoms ranged between 1.1% ("repeated vomiting") and 3.4% ("difficulty swallowing"). Women had higher odds of experiencing "repeated vomiting" and "persistent and recent-onset abdominal pain", but lower odds of experiencing "upper GI bleeding". The proportion of people contacting their GP with each of the four specific alarm symptoms ranged from 24.3% ("upper GI bleeding") to 39.9% ("repeated vomiting"). For each combination of two specific alarm symptoms, at least 52% contacted their GP.
  
  
  CONCLUSIONS
  The specific alarm symptoms of upper GI cancer are not very prevalent in the general population. The proportion of GP contacts with each of the four specific symptoms varied between 24.3% and 39.9%. The proportion of GP contacts was higher in the older age and with combinations of two symptoms.
authors: Research Unit of General Practice, Department of Public Health, University of Southern Denmark , J.B. Winsløws Vej 9A, 5000 Odense C , Denmark.
authors: Sanne
authors: S
authors: Rasmussen
authors: Pia Veldt
authors: PV
authors: Larsen
authors: Rikke Pilsgaard
authors: RP
authors: Svendsen
authors: Peter Fentz
authors: PF
authors: Haastrup
authors: Jens
authors: J
authors: Søndergaard
authors: Dorte Ejg
authors: DE
authors: Jarbøl
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003718:Denmark; D055088:Early Detection of Cancer / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D058006:General Practice / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D062706:Prodromal Symptoms; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D041742:Upper Gastrointestinal Tract / Q000473:pathology*
keywords: Esophageal disorders; gastroduodenal clinical; general