Academic journal article International Journal of Men's Health

What Makes Men Attend Early Detection Cancer Screenings? an Investigation into the Roles of Cues to Action

Academic journal article International Journal of Men's Health

What Makes Men Attend Early Detection Cancer Screenings? an Investigation into the Roles of Cues to Action

Article excerpt

The purpose of the present research was to examine which cues to action prompt men to undergo cancer screenings. The first study sought to identify the cues to action relevant to cancer screening (CS) by conducting structured interviews with 71 men aged 45 to 70 years. The second study investigated the relationships between the elicited cues to action and past CS experience in another sample of men (N = 144). Multivariate analyses of variance found significant differences in mean recall of seven out of ten cues by CS participation status. Recall was higher for participants than non-participants. For most cues the largest difference was found between non- and annual participants. Physician's recommendation was most strongly associated with participation status, followed by the recommendation by family members. Information from health insurance providers was recalled more often by regular cancer screening participants. Mean recall of media cues was high across all groups and no significant differences were observed, pointing to a possible saturation effect of information from the media.

Keywords: men, prostate cancer, cues to action, cancer screening, early detection, preventive behavior


Men have higher levels of cancer incidence and mortality than women; this disparity is seen mainly as a consequence of their more risky lifestyle and their poorer use of primary prevention strategies (Evans, Brotherstone, Miles, & Wardle, 2005). Men are also less likely than women to utilize the health care system for preventive purposes, for instance, obtaining health screenings (Courtenay, 2000, 2003). Evans and colleagues suggest that gender differences in early detection practices may be a contributing factor to the higher cancer mortality in men. In their review they stated that men engage in self-examination less frequently and are more likely to delay reporting cancer symptoms to a physician.

Although no gender difference emerged in the U.S. with regard to the use of colorectal cancer screening, gender specific cancer screenings show such a difference with lower utilization by men than women (Centers for Disease Control and Prevention, 2004). Similarly, a recent Canadian study found a smaller percentage of men aged 40 to 60 years (65%) compared to age-matched women (79%) to have discussed or undergone prostate cancer screening or mammography, respectively (McCreary, Gray, & Grace, 2006). Whereas gender differences in cancer screening participation in the UK appear not as clear-cut and differ by type of cancer screening (Evans et al., 2005), a marked gender gap can be observed in Germany. Since the introduction of a statutory early cancer detection program in 1971, attendance rates have been much lower for men than for women (Altenhofen, 2005). The standard procedure for the early detection of cancer is available to men aged 45 and over consisting of an annual digital examination of the prostate and external examinations of the genitalia. Screening for colorectal cancer starts at age 50.

To explain which factors influence cancer screening attendance a large body of research has been accumulated, mostly focusing on socio-demographic and variables from social cognitive models of health behavior. An example of the latter is the Health Belief Model (HBM; Becker, 1974; Rosenstock, 1966), an influential model originally developed to find answers to the question as to why people underutilize programs designed to prevent or detect asymptomatic disease (Rosenstock, 2000, p. 78). It assumes health behavior to be a direct function of a number of health beliefs and to be triggered by cues to action. While the main health belief variables (i.e., the major dimensions perceived susceptibility and severity, barriers and benefits) have been subject to a large body of empirical research (see Aoun, Donovan, Johnson, & Egger, 2002; Harrison, Mullen, & Green, 1992), cues to action have received less attention in empirical studies. …

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