Dealing with symptoms in the general population: lessons learned from the Danish Symptom Cohort

symptoms ranging from barely noticeable sensations to disturbing discomforts. The causes vary from normal physiological processes and self-limiting benign conditions to life-threatening diseases. Symptom experiences do not occur as stand-alone events but are influenced by an interchange of biological, psychological, and cultural factors, leading to various ways of interpreting and managing symptoms.1 Consequently, many symptoms are managed privately without consulting the healthcare system;2 however, some symptoms should lead to further investigation as they are alarming from a healthcare perspective and timely investigation is warranted.3,4 GPs play an important role in helping patients interpret symptoms;5 however, the healthcare-seeking process is not simple, and numerous factors, including previous experiences, social relations, and support, may contribute in deciding whether or not to seek health care.6 To elucidate how symptoms are interpreted and managed in the general population, we initiated the Danish Symptom Cohort (DaSC), a nationwide webbased survey. In 2012, we invited 100 000 randomly selected individuals aged >20 years to complete a questionnaire covering 44 predefined symptoms comprising both cancer symptoms as well as common symptoms, for example, back pain, urinary incontinence, and tiredness. If responders confirmed a symptom experience, followup questions were asked concerning onset, influence on daily activities, concerns about the symptom, whether the responder had consulted the GP regarding the symptom, and considerations about contacting the GP with the symptom in question. Responders were also asked about smoking status, alcohol intake, and physical activity. For the invitees, socioeconomic status (education, income, cohabitation status, ethnicity, and labour market affiliation) were then collected from national registers7–11 and linked to survey data. In this editorial we summarise the findings from the DaSC studies, highlighting the lessons learned but also pointing to what needs to be further explored in the 10-year follow-up questionnaire, DaSC II, which was distributed in May 2022. The 34 current publications deriving from the DaSC are available online,12 with details of the results and contextualisation of findings within the existing literature.