Men's health has been neglected for too long – prostate cancer is a case in point
Men's health has been neglected for far too long with devastating consequences. Globally, men's life expectancy lags five years behind women's. Men are significantly more likely to develop and die from cancer, heart disease, diabetes and tuberculosis. They are also at much greater risk of dying from suicide or an accident on the roads or at work.
Most senior health decision-makers may be male but this has not stopped men's needs being largely absent from global and national health policy. Only a handful of countries have developed dedicated men's health policies and this is felt on the ground.
For example, when Global Action on Men's Health analysed global and regional policies on sexual and reproductive health, just 16 per cent specifically addressed men's needs. A similar review of policies on primary healthcare found that just seven per cent took explicit account of men.
The barriers that prevent many men using GP services – limited opening hours, user-unfriendly appointment booking systems, an absence of men's health information in waiting rooms – have not been addressed. The inevitable consequence: too many men are diagnosed and treated too late.
Prostate cancer is one of the many men's health issues in urgent need of attention. There have been major advances in treatment over the past 20-30 years but there are still too many blind spots.
Why do so many men, especially in lower-income countries, lack basic information about the disease? How is it that so little is known about how to prevent prostate cancer? Why are so many men, especially Black men and others at higher risk for genetic reasons, diagnosed when their cancers are already advanced? And why is prostate cancer absent from many countries' national cancer plans?
You may not hear much about it but prostate cancer is the third most common cancer worldwide and the most frequently diagnosed cancer in men in 112 countries. The global incidence of the disease is expected to double by 2040 to almost three million new cases a year – and the mortality rate will increase by 85 per cent.
These statistics are not just alarming, they are unacceptable. Every effort must be made to slow down and reverse the trend in order to prevent unnecessary suffering among men and their families.
This is why Global Action on Men's Health is using the platform provided by International Men's Health Week (9-15 June) to call on the World Health Organisation to introduce a Global Prostate Cancer Initiative which covers every stage of the prostate cancer pathway from prevention to palliative care.
This new Global Initiative must include:
National governments being urged to introduce prostate cancer policies or national cancer plans which specifically address prostate cancer
Education and awareness campaigns to provide more accurate information and tackle the stigma many men feel about prostate health
Early diagnosis is essential. Because early-stage prostate cancer is usually symptomless, as many countries as possible should start planning the introduction of organised national screening programmes. Screening could reduce prostate cancer death rates by 35 per cent
There must be a focus on men at highest risk of poor prostate cancer outcomes, particularly Black men, men with a family history of the disease and men from lower socio-economic groups
Men with prostate cancer need quick and free (or at least affordable) access to all effective treatment options as well as psychosocial support
Investments in research, infrastructure, workforce development and treatments are required, especially in lower-income countries where prostate cancer mortality rates are disproportionately high
Alongside a global effort to address the looming crisis of prostate cancer, action is also needed on other key men's health issues. Increasing men's use of primary care is vital. Men's uptake of screening for hypertension, diabetes, high cholesterol and bowel and lung cancers must also be improved.
More health services delivered to where men are – workplaces, fitness and sports venues, places of worship – would help. Men can feel more comfortable and be more receptive in these places than in health clinics.
Men's health literacy can be improved through more targeted information about how to reduce health risks, the red flag symptoms to look out for, and where and how men can get help if they need to.
Men's risk-taking behaviours – smoking, heavy drinking, poor diets – have not been tackled with male-targeted health promotion. Contrast the usually staid approach of healthcare providers with that of commercial advertisers who have long known how to sell men cars and beer.
It is time to put men's health on global and national health agendas. And prostate cancer would not be a bad place to start.
www.gamh.org.
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