Gender Differences in Cancer Mortality Risk Perceptions and Screening Behaviors among Adults 40-60 Years of Age
McCreary, Donald R., Gray, Ross E., Grace, Sherry L., International Journal of Men's Health
The purpose of this study was to examine gender differences in cancer mortality risk perceptions and preventive screening behaviors as well as perceptions of gender differences in types of cancer risks. A telephone survey was administered to 300 men and 300 women between 40 and 60 years of age, all of whom were contacted via a random digit dialing procedure. Findings showed that 62% of respondents believed that prostate cancer was the most frequent cause of cancer mortality among men (12% actual) while breast cancer was thought to be the most frequent cause reported among 80% of women (17% actual). It was determined that 79% of men and women are discussing or receiving preventive screening for prostate and breast cancer, respectively, and that these frequencies increase significantly after age 50. Finally, most respondents believed that women had higher rates of cancer morbidity and mortality than men. These results suggest that an increase in cancer mortality risk awareness is needed among both men and women. The elevated risks among men need to be made salient, and prevention campaigns that target men's mortality risks need to be developed.
Keywords: gender differences, cancer mortality, risk perceptions, prostate cancer, breast cancer, screening behaviors
Cancer is currently a leading cause of death among Canadians. According to the National Cancer Institute of Canada (NCIC), the 2004 age-standardized incidence rates for cancer were 449 per 100,000 men and 351 per 100,000 women (NCIC, 2004). The most frequently diagnosed cancer for men was prostate cancer (121/100,000) while the most frequently diagnosed cancer for women was breast cancer (106/100,000). The average treatment success rate for both of these cancer types is high. As a result, for both males and females the most frequent cause of death from cancer was lung cancer (65/100,000 for men; 40/100,000 for women). The mortality rates for prostate and breast cancers were close to half these estimates (27/100,000 and 24/100,000, respectively).
The NCIC statistics also show that, once women's greater longevity is taken into account, men are not only more likely to get cancer, but they are also more likely to die from it. That is, men are 28% more likely than women to be diagnosed with cancer, but of those diagnosed, men are 47% more likely than women to die from cancer (NCIC, 2004). These gender differences in morbidity and mortality have been stable since at least 1969 (NCIC, 1998).
Although lung cancer is the leading cancer-related cause of death in Canada, most media and research attention is devoted to breast cancer and, more recently, prostate cancer. Given the widespread focus on these two types of cancer, social science theories of media influence such as the Cultivation Hypothesis (Gerbner, Gross, Morgan, & Signorielli, 1994; McCreary, 1997; McCreary & Sadava, 1999) predict that people should overestimate men's likelihood of dying from prostate cancer and women's likelihood of dying from breast cancer. Furthermore, because the media focus on prostate cancer is relatively new and also because there has been a relative absence of men in the social marketing campaigns for cancer prevention, these theories also predict that people will believe women are at greater risk than men for being diagnosed with cancer and experiencing a cancer-related death.
Early detection is seen as important for reducing cancer mortality. The two keystones to ensuring early detection are awareness and screening. This is especially important for middle-aged men and women, since this is the time when risk increases and, consequently, most will begin to submit to more extensive screening by their physicians (Feightner, 1994; Morrison, 1994). However, there are differing opinions about when preventive screening should begin. The Canadian Task Force on Preventive Health Care (CTFPHC) does not recommend regular, preventive prostate cancer screening (Feightner, 1994) because the scientific evidence has not been compelling enough (e. …