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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Self-reported symptoms and healthcare seeking in the general population -exploring “The Symptom Iceberg”

BMC Public Health > Ausgabe 1/2015
Sandra Elnegaard, Rikke Sand Andersen, Anette Fischer Pedersen, Pia Veldt Larsen, Jens Søndergaard, Sanne Rasmussen, Kirubakaran Balasubramaniam, Rikke Pilsgaard Svendsen, Peter Vedsted, Dorte Ejg Jarbøl
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests. The study is financially supported by the Novo Nordisk Foundation, the Danish Cancer Society and “The Danish Research Centre for Cancer Diagnosis in Primary Care – (CaP)”. The funders have not been involved in the design or development of the study.

Authors’ contributions

SE, SR, KB and DJ participated in the design of the study, development of the questionnaire, the logistics concerning the survey and the drafting of the manuscript. SE moreover did the main work in forming the manuscript and carried out the statistical analyses. RSA, AFP, JS, RPS and PV participated in the design of the study, development of the questionnaire and drafting of the manuscript. PVL participated in the development of the questionnaire, drafting of the manuscript and the statistical considerations concerning the survey and analyses. All authors read and approved the final manuscript.



Research has illustrated that the decision-making process regarding healthcare seeking for symptoms is complex and associated with a variety of factors, including gender differences. Enhanced understanding of the frequency of symptoms and the healthcare seeking behaviour in the general population may increase our knowledge of this complex field.
The primary objective of this study was to estimate the prevalence of self-reported symptoms and the proportion of individuals reporting GP contact, in a large Danish nationwide cohort. A secondary objective was to explore gender differences in GP contacts in response to experiencing one of the 44 predefined symptoms.


A Danish nationwide cohort study including a random sample of 100,000 individuals, representative of the adult Danish population aged 20 years or above. A web-based questionnaire survey formed the basis of this study. A total of 44 different symptoms covering a wide area of alarm symptoms and non-specific frequently occurring symptoms were selected based on extensive literature search. Further, items regarding contact to the GP were included. Data on socioeconomic factors were obtained from Statistics Denmark.


A total of 49,706 subjects completed the questionnaire. Prevalence estimates of symptoms varied from 49.4 % (24,537) reporting tiredness to 0.11 % (54) reporting blood in vomit. The mean number of reported symptoms was 5.4 (men 4.8; women 6.0).
The proportion of contact to the GP with at least one symptom was 37 %. The largest proportion of GP contacts was seen for individuals reporting blood in the urine (73.2 %), whereas only 11.4 % of individuals with increase in waist circumference reported GP contact. For almost 2/3 of the symptoms reported, no gender differences were found concerning the proportion leading to GP contacts.


Prevalence of symptoms and GP contacts are common in this overview of 44 different self-reported symptoms. For almost 2/3 of the reported symptoms no gender differences were found concerning the proportion leading to GP contacts. An enhanced understanding of healthcare seeking decisions may assist healthcare professionals in identifying patients who are at risk of postponing contact to the GP and may help development of health campaigns targeting these individuals.
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