Urological symptoms among 23,240 men in the general danish population – concerns about symptoms, their persistence and influence on primary care contacts

Abstract

Objective: To analyse possible associations between men’s likelihood of contacting a general practitioner (GP) for urological symptoms and the persistence of the symptoms, the influence on daily activities and the level of concern about the symptoms.

Design: Web-based nationwide cross-sectional questionnaire study.

Setting: The general population in Denmark.

Subjects: 48,910 randomly selected men aged 20+ years.

Main outcome measures: Urological symptom prevalence and odds ratios for GP contact with urological symptoms in regard to concern for the symptom, influence on daily activities and the persistence of the symptom.

Results: Some 23,240 men responded to the questionnaire, yielding a response rate of 49.8%. The prevalence of at least one urological symptom was 59.9%. Among men experiencing at least one urological symptom almost one-fourth reported contact to general practice regarding the symptom. Approximately half of the symptoms reported to be extremely concerning were discussed with a GP.

Conclusion: Increased symptom concern, influence on daily activities and long-term persistence increased the likelihood of contacting a GP with urological symptoms. This research points out that guidelines for PSA testing might be challenged by the high prevalence of urological symptoms.

Key points

•  The decision process of whether to contact the general practitioner (GP) is influenced by different factors, but contradictory results has been found in triggers and barriers for help-seeking with urological symptoms.

•   • Increased symptom concern, influence on daily activities and long-term persistence consistently increased the likelihood of contacting a general practitioner with urological symptoms in men.

•   • Only 50% of the symptoms reported to be extremely concerning were however discussed with the GP.

•   • Guidelines for PSA testing might be challenged by the high prevalence of urological symptoms.

Key words:

• Help-seeking behaviour
• patient acceptance of health care
• urination
• urinary incontinence
• symptom assessment
• general practice

Acknowledgements

The survey was conducted in collaboration between University of Southern Denmark and Aarhus University. The project is part of the research portfolio at the Research Centre for Cancer Diagnosis in Primary Care (CaP) and is financially supported by the Novo Nordisk Foundation and the Danish Cancer Society.

The authors would like to thank Maria Munch Storsveen for statistical support, and Merete Moll Lund for proofreading the manuscript.

Ethics

The participants were informed that the study did not include clinical follow-up, and therefore they were advised to contact a general practitioner in case of concern or worry. The Regional Scientific Ethics Committee for Southern Denmark did not have any objections. This study was approved by The Danish Data Protection Agency: journal no. 2011-41-6651.

Disclosure statement

The author declares no competing interests.

Funding

Novo Nordisk Foundation and the Danish Cancer Society.

The funders have not been involved in the design or development of the study.

Additional information

Notes on contributors

Majken Solvang

Majken Solvang is a Medical Doctor, PhD, working as a registrar in the Region of Southern Denmark.

Sandra Elnegaard

Sandra Elnegaard is a Medical Doctor, PhD, working as a registrar in the Region of Southern Denmark.

Dorte Ejg Jarbøl

Dorte Ejg Jarbøl is a General Practitioner, PhD, working as professor at the Research Unit of General Practice, Department of Public Health, University of Southen Denmark.