Masculinity beliefs and colorectal cancer screening in male veterans.

Abstract

As the third most common cause of cancer death among United States men, colorectal cancer (CRC) represents a significant threat to men’s health. Although adherence to CRC screening has the potential to reduce CRC mortality by approximately half, men’s current rates of adherence fall below national screening objectives. In qualitative studies, men have reported forgoing screenings involving the rectum (e.g., colonoscopy) due to concern about breaching masculinity norms. However, the extent to which masculinity beliefs predict men’s CRC screening adherence has yet to be examined. The current study tested the hypothesis that greater endorsement of masculinity beliefs (i.e., self-reliance, risk-taking, heterosexual self-presentation, and primacy of work) would be associated with a lower likelihood of adherence to CRC screening with any test and with colonoscopy specifically. Participants were 327 men aged 51–75 at average risk for CRC who were accessing primary care services at a Midwestern Veterans Affairs Medical Center. Contrary to hypotheses, masculinity beliefs did not predict CRC screening outcomes in hierarchical regression analyses that controlled for demographic predictors of screening. Although results are largely inconsistent with masculinity theory and prior qualitative findings, further research is needed to determine the degree to which findings generalize to other populations and settings.

Psychometric Properties and Analysis of the Masculinity Barriers to Medical Care Scale Among Black, Indigenous, and White Men

“…Compared with their Indigenous and NH White counterparts, NH Black men had the lowest mean scores on this factor, indicating that they experienced the lowest masculinity barriers focused on negative attitudes. These findings were contrary to our hypothesis and prior research on the relationships among masculine role norms, medical mistrust, and engagement in preventive health behaviors such as screening for early detection of CRC in NH Black men ( Christy et al, 2017 ; Earl et al, 2021 ; Hammond 2010 ; Nobis & Sanden, 2008 ; Rogers et al, 2017 , 2020 ). Several studies outline how endorsement of traditional masculinity norms—which value strength, independence, and self-reliance—can result in delaying medical care and reluctance to seek health services, especially among NH Black men ( Christy et al, 2017 ; Hammond 2010 ; Nobis & Sanden, 2008 ; Rogers et al, 2017 , 2020 ).…”

“…These findings were contrary to our hypothesis and prior research on the relationships among masculine role norms, medical mistrust, and engagement in preventive health behaviors such as screening for early detection of CRC in NH Black men ( Christy et al, 2017 ; Earl et al, 2021 ; Hammond 2010 ; Nobis & Sanden, 2008 ; Rogers et al, 2017 , 2020 ). Several studies outline how endorsement of traditional masculinity norms—which value strength, independence, and self-reliance—can result in delaying medical care and reluctance to seek health services, especially among NH Black men ( Christy et al, 2017 ; Hammond 2010 ; Nobis & Sanden, 2008 ; Rogers et al, 2017 , 2020 ). Fewer interactions with health-care providers can impede the patient–provider trust-building process, which is essential for reducing medical mistrust barriers ( Hammond, 2010 ; Idan et al, 2020 ; LaVeist et al, 2009).…”

“…Harris et al (2011) reported that the behaviors and interactions of a sample of NH Black men attending college were influenced by a critical element of masculinity that involved appearing unemotional and unfazed. Similarly, other studies have demonstrated how placing a high value on masculinity characteristics such as fear of showing weakness and vulnerability are aspects of restrictive emotionality ( Christy et al, 2017 ; Hammond, 2010 ; Nobis & Sanden, 2008 ). Because Black men have historically endorsed traditional masculinity norms to preserve their soundness of mind, additional research is needed to better understand why NH Black men in our study reported fewer masculinity barriers to Acknowledging Emotions and Health Issues.…”

“… Hammond (2010) reported medical mistrust being greater when individuals perceived race-based treatment differences. Numerous studies have demonstrated that heterosexual self-preservation, a characteristic of masculinity, negatively corresponds with engaging in preventive health measures such as CRC screening, which are inherently invasive in nature and induce a feeling of vulnerability ( Christy et al, 2017 ; Getrich et al, 2011 ; Rogers et al, 2017 , 2020 ; Vandello & Bloom, 2013 ; Winterich et al, 2009 ). These previous findings may explain why NH Black men reported fewer masculinity barriers in our study.…”

Too masculine for healthcare, too feminine for intense sports: correlation between gender conformity and pro-health behaviours

“…Moreover, some preventive screenings -such as prostate examination or colonoscopy -are perceived as an attack on one's masculinity, and thus gender role attitudes may make it harder for men to be willing to undergo regular check-ups [50]. However, this does not hold for war veterans, for whom one study did not reveal any relationship between masculinity beliefs and colorectal cancer screening adherence or colonoscopy [51]. However, the authors themselves pointed out that this group constitutes a very particular subset of men, and more studies on other social groups are needed.…”