Barriers to contacting general practice with alarm symptoms of colorectal cancer: a population-based study

Dorte Ejg Jarbøl, Sanne Rasmussen, Rikke Pilsgaard Svendsen, Kirubakaran Balasubramaniam, Peter Haastrup, Maja Stryhn Petersen, Mojib Fallah, Sandra Elnegaard

Research output: Contribution to journalJournal articleResearchpeer-review


A prerequisite for general practitioners (GPs) being able to refer patients with cancer alarm symptoms for further investigations is that individuals present to the GP. Knowledge of barriers to help-seeking is, however, sparse.

Objectives. The aim of this study was to analyse associations between the experience of recent-onset alarm symptom of colorectal cancer and four different barriers towards GP contact.

A nationwide web-based cohort survey was conducted in 100000 individuals aged 20 years or above, randomly selected from the Danish Civil Registration System. Items regarding experience of four predefined alarm symptoms of colorectal cancer (rectal bleeding, abdominal pain, change in stool texture and change in stool frequency), decisions about contact to GPs and barriers towards GP contact were included.

A total of 37455 respondents over 40 years (51.8%) completed the questionnaire. The proportion of individuals with no contact to the GP varied between 69.8% and 79.8% for rectal bleeding and change in stool frequency, respectively. The most widely reported barriers were being worried about wasting the doctor’s time and being too busy to make time to visit the doctor. Men with rectal bleeding significantly more often reported being worried about what the doctor might find. The proportion of individuals who reported barriers was, in general, higher among the youngest age group.

Barriers to contacting the GP were frequent when experiencing alarm symptoms of colorectal cancer. Reporting the different barriers was significantly associated with gender and age.
Original languageEnglish
JournalFamily Practice
Issue number4
Pages (from-to)399-405
Publication statusPublished - 23. Jul 2018


  • Behaviour and behaviour mechanisms
  • Colorectal neoplasms
  • General practice
  • Help-seeking behaviour
  • Primary health care
  • Signs and symptoms
  • Help-Seeking Behavior
  • Age Factors
  • Cross-Sectional Studies
  • General Practitioners
  • Humans
  • Middle Aged
  • Male
  • Colorectal Neoplasms/diagnosis
  • General Practice
  • Sex Factors
  • Adult
  • Female
  • Surveys and Questionnaires
  • Aged
  • Internet
  • Cohort Studies


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