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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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.
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Every country should have a strategy for tackling prostate cancer with dedicated screening programs for men over 50, a leading health charity has said. Global Action on Men's Health, the leading international charity for men's health, is calling for prostate cancer – now the third most common cancer worldwide – to be dramatically elevated on the health agenda. On Monday it will launch a campaign to encourage all countries with adequate resources, including the UK, to launch national screening for the disease in a bid to cut unnecessary deaths. It will also call for the World Health Organization (WHO) to introduce a Global Prostate Cancer Initiative which 'covers every stage of the prostate cancer pathway from prevention to palliative care'. Prostate cancer is now the most frequently diagnosed cancer in men in 112 countries and the leading cause of cancer death among men in 48 countries. In England, it is now the most common cancer, killing some 12,000 men every year, according to Prostate Cancer UK. Writing in today's Telegraph, Peter Baker, the director of Global Action on Men's Health, said that men were being short-changed when it comes to healthcare. 'Men's health has been neglected for far too long with devastating consequences,' he writes. '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.' Mr Baker calls for reform across health care systems – ensuring men have better access to GPs, for instance – and believes that a focus on prostate cancer is a good place to start. 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This in turn led to many unnecessary prostate removals and biopsies being performed, meaning the risks outweighed the benefits of running national screening programmes. But now, with the advent of more specific blood tests and high resolution MRI scans, which allow for much more accurate biopsies, the balance has changed, with several high quality studies showing the benefit of screening. The largest of these studies was the European Randomised Study of Screening for Prostate Cancer (ERSPC), which included over 182,000 men and showed a 20 per cent reduction in prostate cancer mortality among those screened. Another study in Gothenburg, Sweden, found that after 18 years of follow-up, men in the screening group were 35 per cent less likely to die from prostate cancer than men who were not screened. Men who started screening at age 55-59 were 53 per cent less likely to die. Professor Jonas Hugosson, a urologist at University of Gothenburg in Sweden who led the Swedish study, said he expected national screening for prostate cancer to be rolled out across most western European nations in the next few years. In Sweden a move to nationwide screening was already progressing and in Norway he expected a national screening program to be announced shortly, he said. However, just as with the roll out of breast cancer screening more than three decades ago, it would take most countries many years to gear up. 'In my view, we have quite a new situation today, and I think it's time for the health authorities to take a new standpoint,' he said. 'I'm quite sure about that and we will see screening come all over Europe during the coming years, but it takes 10 years to build up, at least.' 'Alarming and unacceptable' rise in cases The NHS in England does not have a dedicated men's health strategy but one has been promised by the end of the year by the new Health Secretary, Wes Streeting. Although the new strategy is unlikely to include the imminent launch of a national screening program for prostate cancer – the UK currently does not have the MRI machines and trained staff needed to launch one – it may include screening for high risk groups. These include black men, who have double the normal risk, and men with a family history of prostate and related cancers – including breast and ovarian cancer on the female side. In October last year, six-time Olympic cycling champion Sir Chris Hoy, 49, revealed that he had terminal prostate cancer. Both his father and grandfather had the disease but his was not caught by early testing, sparking an outcry. 'The rapid rise in prostate cancer cases is not just alarming, it is also unnecessary and therefore unacceptable,' said Global Action on Men's Health. 'Prostate cancer is currently inadequately addressed in global and national cancer policies'. In addition to national testing where possible, the charity is calling for the WHO to support a new Global Prostate Cancer Initiative covering 10 areas. These include governments being urged to introduce national cancer plans which specifically address prostate cancer with clear performance indicators, education programmes to raise awareness and tackle stigma, and investments in research, infrastructure, workforce development and treatments for prostate cancer. The WHO does not currently have a programme that focuses specifically on prostate cancer but 'integrates' it to its wider program for tackling cancer more generally. Cervical cancer, in contrast, has a dedicated programme dedicated to its global eradication but that is because the HPV vaccine makes it possible to wipe out the disease completely. Dr André Ilbawi, technical lead for cancer control at the WHO, welcomed the prostate campaign launched by Global Action on Men's Health, and said the disease was moving up the WHO's agenda. The organisation had just five countries involved in its cancer programme in 2015 to but has 100 today. 'We see prostate cancer as a priority and, in 2023, elevated it in our guidance because it can be treated,' said Dr IIbawi. 'If treatment is available, survival is extremely high. And if treatments are not available, those men will die. 'We agree that prostate cancer should be seen in the cancer agenda as high impact, cost-effective and meeting community needs'.
