Is lack of awareness and reluctance to go to the doctor leading to increased cancer deaths in men?

Is lack of awareness and reluctance to go to the doctor leading to increased cancer deaths in men?

Figures released today show a worrying trend – UK men are more likely to get cancer than women, and also more likely to die from the disease.

The report (pdf), compiled by Cancer Research UK, the National Cancer Intelligence Network (NCIN), Leeds Metropolitan University and the Men’s Health Forum shows that men are 40 per cent more likely to die from cancer than women overall, and 16 per cent more likely to get the disease.

To find out if this was due to cancers that predominantly affect only one sex, the researchers removed certain cancers from their equation – namely sex-specific cancers (such as prostate and cervical cancer), breast cancer (which mainly affects women, although men can still get it) and lung cancer (which affects 8,000 more men than women every year).

The team found that when they looked at data from cancers that affected both men an women, the difference became even more striking. Men were 60 per cent more likely to get cancer than women, and 70 per cent more likely to die from it.

These figures are concerning not only for men, but for their families too. But why does this difference exist, and what can we do about it?

Biology, lifestyle or the ‘ostrich factor’?
This particular gender gap is mysterious because there’s no significant biological reason as to why men should be more susceptible to many types of cancer than women.  But men were more likely to die from any of the cancers investigated in the report, and – apart from malignant melanoma – were also more likely to develop the disease in the first place. So what’s the cause?

Experts point the finger at two possible explanations.  Firstly, lifestyle factors.  As well as smoking, UK men are drinking increasing amounts of alcohol, putting on weight, and taking less exercise.  All of these things are known risk factors for several types of cancer.  But women are overindulging in unhealthy behaviour too (although not as much), so that’s not the whole story.

Secondly, the report’s authors point the finger at a deeper-rooted issue with the male psyche – the tendency to hide one’s head in the sand when it comes to health matters.

Throughout their lives, women tend to have frequent contact with health professionals – for example, when seeking contraception or during pregnancy, birth and child-rearing. This provides opportunities to discuss any worrying symptoms, and to pick up information about cancer prevention and symptoms.

Women are also invited to go for cervical and breast cancer screening at the GP’s surgery or a mobile clinic, providing more opportunities for information and discussion about health.  Both men and women can take part in bowel cancer screening, but this test is done at home.

In addition, women’s magazines are packed full of messages about health and cancer awareness, such as the heavy coverage of cervical cancer in response to Jade Goody’s story.   While there are a number of publications aimed at male health and fitness, health messages for men don’t seem to have reached the level of saturation they have achieved in the female media market.

Researching the reasons
Stereotypically, men are less likely to go to the doctor if they have early symptoms of cancer, such as a persistent cough, a change in bowel habit or problems with peeing (early symptoms of lung, bowel and prostate cancer, respectively). As Professor David Foreman, information lead at the NCIN puts it,

Men have a reputation for having a ‘stiff upper lip’ and not being as health conscious as women.

At Cancer Research UK, we often hear stories from female supporters about how they had to pester their menfolk to visit the doctor, but by the time they finally did, it was too late.  Every story is a tragedy for that family, and another reason why we need to put early detection and symptom awareness high on our list of priorities.

But as a science-based organisation, we can’t make decisions and strategy based on stereotypes and personal stories – we need hard data.

So last year, we helped launch NAEDI – the National Awareness and Early Detection Initiative – a joint initiative led by Cancer Research UK and the Department of Health (DoH) aimed at improving early diagnosis of cancer, which we hope will save many lives.

An important part of NAEDI’s work will be to carry out research as to why people put off going to the doctor with early cancer symptoms, and how best to get across messages about the signs of cancer.  Armed with this information, we will be able to target the right messages to the right people, at the right time.

Getting the message across
As part of NAEDI, some interesting male-focused awareness projects have already started up.  For example, the DoH and the Football Foundation are joint-funding a pilot programme called “Ahead of the Game”, aiming to use local football clubs to raise awareness of lung, bowel and prostate cancers in men aged 55 and over – a crucial age when it comes to spotting the earliest signs of cancer.

And the DoH and the NHS Cancer Screening Programmes have joined forces with Cancer Research UK’s Bobby Moore Fund to raise awareness of bowel cancer. You may have seen the “Moore to know” campaign posters around the place.

Football is just one way to reach men with messages about cancer, but of course it’s not the only way.  It’s clear that we need more research to help plan awareness campaigns and policy. But also it seems that we, as a society, need to somehow encourage a shift in attitudes if we’re to help more dads, granddads, husbands, brothers and sons to beat cancer.

Kat

Further information