{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:59:28Z","timestamp":1772611168087,"version":"3.50.1"},"reference-count":44,"publisher":"BMJ","issue":"7","funder":[{"name":"The Region of Southern Denmark"},{"DOI":"10.13039\/501100009708","name":"The Novo Nordisk Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100008363","name":"The Danish Cancer Society","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,5,14]]},"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the proportion of contacts to general practitioner (GP) with recent onset gynaecological cancer alarm symptoms (pelvic pain, postmenopausal bleeding, bleeding during intercourse or pain during intercourse) and to analyse the associations between lifestyle factors, socioeconomic status and GP contact for these symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional survey combined with data from national registers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The general Danish population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 25 866 non-pregnant women \u226520 years completed the survey. Women reporting at least one of four gynaecological alarm symptoms within the preceding 6\u2009months form the study base (n=2957).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The proportion of women reporting GP contact ranged from 21.1% (pain during intercourse) to 32.6% (postmenopausal bleeding). Women aged 60+ years had higher odds of reporting GP contact for at least one of the four gynaecological cancer alarm symptoms compared with those aged 20\u201339 years (OR 2.56, 95%\u2009CI 1.69 to 3.89), and immigrants had higher odds of reporting GP contact for at least one of the symptoms (OR 1.56, 95%\u2009CI 1.13 to 2.15) compared with ethnic Danish individuals. Among those reporting postmenopausal bleeding and\/or bleeding during intercourse, women in the age group 60+ years had higher odds of reporting GP contact compared with those aged 20\u201339 years (OR 2.79, 95%\u2009CI 1.33 to 5.87). A high educational level (&gt;12 years) was positively associated with reporting GP contact for postmenopausal bleeding and\/or bleeding during intercourse compared with a low educational level (&lt;10 years) (OR 2.23, 95%\u2009CI 1.19 to 4.19). No associations were found with lifestyle factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Few women contacted their GP with recent onset gynaecological cancer alarm symptoms. Higher age, being immigrant and higher educational level increased the odds of GP contact. Future studies should explore the reasons for these findings as this may aid in prompting early diagnosis and thereby improve the prognosis of gynaecological cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-021815","type":"journal-article","created":{"date-parts":[[2018,7,6]],"date-time":"2018-07-06T00:06:08Z","timestamp":1530835568000},"page":"e021815","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Lifestyle, socioeconomic status and healthcare seeking among women with gynaecological cancer alarm symptoms: a combined questionnaire-based and register-based population study"],"prefix":"10.1136","volume":"8","author":[{"given":"Kirubakaran","family":"Balasubramaniam","sequence":"first","affiliation":[{"name":"Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Elnegaard","sequence":"additional","affiliation":[{"name":"Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanne","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter Fentz","family":"Haastrup","sequence":"additional","affiliation":[{"name":"Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren\u00e9 dePont","family":"Christensen","sequence":"additional","affiliation":[{"name":"Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"S\u00f8ndergaard","sequence":"additional","affiliation":[{"name":"Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorte Ejg","family":"Jarb\u00f8l","sequence":"additional","affiliation":[{"name":"Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,7,5]]},"reference":[{"key":"2025121407464902000_8.7.e021815.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62231-3"},{"key":"2025121407464902000_8.7.e021815.2","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2015.48"},{"key":"2025121407464902000_8.7.e021815.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2012.06.033"},{"key":"2025121407464902000_8.7.e021815.4","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp09X420860"},{"key":"2025121407464902000_8.7.e021815.5","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2012.68"},{"key":"2025121407464902000_8.7.e021815.6","unstructured":"The Danish National Board of Health. 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