Cancer Care: Do Men Still Lag?

by Rick Blizzard, D.B.A.
Healthcare Editor

The "c" word can scare anybody. The prospect of regular cancer screenings, though they may save your life, is hardly pleasant because it requires confronting the possibility that the results may not be good. Ignorance is bliss, even though it may also be deadly.

Among men, that natural hesitation may be compounded by social factors. In a WebMD article, Dr. John W. Saultz, professor and chairman of family medicine at Oregon Health Sciences University, notes that men aren't conditioned to receive preventative care. As they become adults, Dr. Saultz says, "women see physicians for preventive gynecologic or maternity care and establish a lifelong pattern for seeing physicians. Men do not."

But Dr. Saultz goes on to say that men begin to think about health in preventative terms when they reach 40. Gallup data indicate that, when it comes to cancer screening, though younger men may have some catching up to do, older men are being screened for gender-specific cancer at similar rates as women.

In its April 2001 "Health of the Nation" poll*, Gallup asked 555 females** if they had ever had a mammogram, and 445 males** if they had ever had a digital rectal exam or prostate-specific antigen (PSA) blood test to check their prostate. The tests are similarly important: the mortality rates for the two types of cancer are similar (the Center for Disease Control estimates that the average mortality rate -- i.e., deaths per 100,000 persons -- between 1994 and 1998 was 24.2 for breast cancer, and 23.7 for prostate cancer), and early detection is critical in each case.

According to the Gallup study, among 217 female respondents 40 years and older, 86% reported having a mammogram at some point in the past. Seventy-four percent (74%) of men said they had ever had a rectal exam to check their prostate.

A mounting body of evidence indicates PSA tests help prevent prostate cancer deaths. According to Consumer Reports on Health, the number of prostate cancer deaths in the U.S. fell by 16% between 1991, when PSA testing became widespread, and 1997. Forty-nine percent (49%) of men 40 years of age and older report having ever had a PSA test.

But this is perhaps not a fair comparison, since routine mammograms are recommended for women over 40, while men are generally advised to begin annual rectal exams and PSA tests once they reach 45 or 50. A closer look at the numbers for men suggests that the incidence of preventative care skews toward the oldest age group -- 69% of those 40 to 64 say they have had a rectal exam, while 40 of the 46 male respondents 65 and older say the same (though that group is too small to be representative of the larger population). Among older men at least, the data seem to indicate that the message regarding the importance of preventative care is getting through.

Ben Klima and Steve Crabtree contributed to this article.

*Results are based on telephone interviews with 1,000 adults, ages 18 and older, conducted April 11-29, 2001. For results based on this sample, one can say with 95% confidence that the margin of sampling error is ±3 percentage points.  

**The margin sampling error for the male and female groups separately is ±5 percentage points.

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