Professional Documents
Culture Documents
Cancer in men
Cancerinmen
Reducing incidenceandmortality
18/03/2014
Cancerinmen
Reducing incidenceandmortality
ExcessCancerBurdeninMen. C.R.U.K.,2103
18/03/2014
ExcessCancerBurdeninMen. C.R.U.K.,2103
Cancermortalityrateratiosmen/women
3.50
3.00
2.89
2.89
2.50 2.21 2.01 2.00 1.65 1.50 1.70 1.58 1.53 1.92 1.62 1.42 1.27
1.54
1.00
0.50
ExcessCancerBurdeninMen.C.R.U.K.,2013
18/03/2014
Cancerinmen
Reducing incidenceandmortality
Maledeathsunder75 (allcauses)
Femaledeathsunder75 (allcauses)
26% 42%
ReducingprematuredeathsisanNHSOutcomesFrameworkindicator
Cancerincidencebysexanddeprivationindicator
OfficeforNationalStatistics:HealthStatisticsQuarterly
18/03/2014
Cancerinmen
Reducing incidenceandmortality
Cancerinmen
Reducing incidenceandmortality
Whydomenhavehighercancerratesthanwomen?
MenandCancer:SavingLives.MensHealthForum2013
18/03/2014
Cancerinmen
Reducing incidenceandmortality
Whydomenhavehighercancerratesthanwomen? Biologicalexplanations
Therearenowellestablishedbiologicalexplanationsforhighercancerratesinmen. Therearesomehypothesesbutatthemoment,thesehavethepotentialonlytooffer marginalexplanations: Femalesexhormonesmaybeprotectiveagainstsomecancerstosomeextent W Women mayderive d i someprotection i from f their h i morevigorous i immune i systems Menmaybemoresusceptibletooxidativedamagetobodycells
Notethatsomebiologicalfactorspointtentativelytowardsthepossibilityofhigher cancerratesinwomen.
MenandCancer:SavingLives.MensHealthForum2013
Cancerinmen
Reducing incidenceandmortality
Whydomenhavehighercancerratesthanwomen? Lifestylerelatedexplanations
Mostplausibleexplanationsofhighermaleratesofcancerarerelatedtogender differencesinlifestyles althoughthereisnodataquantifyingtheextenttowhich thesedifferencesexplaingenderdifferencesinincidence
18/03/2014
Cancerinmen
Reducing incidenceandmortality
Whydomenhavehighercancerratesthanwomen? Lifestylerelatedexplanations
Menaremorelikelytodrinkalcoholtoexcess(38%v16%) Menaremorelikelytosufferworkrelatedexposureto carcinogens *** Menaremorephysicallyactivethanwomenbutbothsexes havelowratesofphysicalactivityoverall
Whydomenhavehighercancerratesthanwomen? Lifestylerelatedexplanations
Percentages of men and women exhibiting 2/3 or 3/3 risk behaviours, by social class (smoking, harmful levels of alcohol consumption, poor diet)
Dept.OfHealth.HealthSurveyforEngland2003
18/03/2014
Cancerinmen
Reducing incidenceandmortality
Whydomenhavehighercancerratesthanwomen? Symptomawareness
CancerAwarenessMeasure.CancerResearchUK,2010
Cancerinmen
Reducing incidenceandmortality
Whydomenhavehighercancerratesthanwomen? Useofservices
MenvisittheGPlessoftenthanwomen,evenaftercontrolling forreproductionrelatedconsultationsbywomen
18/03/2014
Domenconsultlessthanwomen?AnanalysisofroutinelycollectedUKgeneralpracticedata WangY,HuntK,NazarethI,FreemantleN,andPetersenI.BMJ,2013
Cancerinmen
Reducing incidenceandmortality
Oncediagnosed,menandwomenvisit theGPwithroughlyequalfrequency
18/03/2014
Cancerinmen
Reducing incidenceandmortality
Whydomenhavehighercancerratesthanwomen? Useofservices
Menarelesslikelytotakeuptheofferofscreeningforbowel cancer(56%v51%),eventhoughmenare60%morelikelyto developbowelcancer
Uptake by area-level deprivation gradient (grey dots represent individual postcode sectors stratified by age and gender) with separate regression lines for gender and age groups.
von Wagner C et al. Int. J. Epidemiol. 2011;ije.dyr008 Published by Oxford University Press on behalf of the International Epidemiological Association The Author 2011; all rights reserved.
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18/03/2014
Cancerinmen
Reducing incidenceandmortality
Howcanwereduce d cancerincidenceinmen?
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18/03/2014
Cancerinmen
Reducing incidenceandmortality
Cancerinmen
Reducing incidenceandmortality
Howcanwereducecancerincidenceinmen? Tryoutsomeoftheapproachesthatwethinkmaybe effectivewithmen: Permissionorlegitimation Directiveinformation Workplace p basedinterventions Opportunisticinterventionsaimedatmen Phoneoremailconsultations Helpboystodevelophelpseekingskills
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18/03/2014
Cancerinmen
Reducing incidenceandmortality
Howcanwereducecancerincidenceinmen? Weneedmoreandbetterresearch: Toreducethepercentageofcancersthatcurrentlyhave noknowncause and Toquantifytheproportionofthegenderdifferencethat cancurrentlybeexplainedbyknowncauses and Tobetterunderstandhowtodeveloppublichealth interventionsthatareeffectivewithmen.
Cancerinmen
Reducing incidenceandmortality
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18/03/2014
Cancerinmen
Reducing incidenceandmortality
Cancerinmen
Reducing incidenceandmortality
david.wilkins@menshealthforum.org.uk
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