Why Aren’t We Doing More To Stop Men Dying Of Cancer?

'Historically, there has been more focus on women,

even though the outcome is worse for men'

By Peter Lloyd: Their unexpected deaths caused an outpouring of public grief. But, in addition to making us all terribly sad, the loss of David Bowie, Alan Rickman and Motorhead's Lemmy Kilmister earlier this month also reinforced the need to address an inconvenient truth around healthcare equality.
According to the Office for National Statistics, men don't just lead women in succumbing to nine of the top 10 killer diseases, including heart disease, stroke, pneumonia, diabetes and cirrhosis of the liver – you know, the really fun ones – we also die five years earlier than women, as part of a life expectancy gap that's swollen 400 per cent in 90 years.
It hasn't always been this way. Back in the early 1900s, men's lifespans lagged just one year behind their female counterparts, which means something relatively recent has gone wrong.

'Ironically, charities such as Cancer Research – which flags up these issues – still ban men and boys from some of their annual fundraisers.'

This is particularly true when it comes to cancer. Not just because it claimed the lives of Bowie et al – brilliant men who surely should've lived way beyond 70 – but because official numbers by Cancer Research UK show that men are 16 per cent more likely to get every unisex form of the disease, and are then 40 per cent more likely to die from it.

Not that we're genetically programmed to snuff it first, of course. It's more a complicated mix of external factors. But what are they? And what can we do to change them?
"Worryingly, we don't really know why women live longer," says Professor Karol Sikora, a world-respected oncologist and campaigner for better universal cancer treatment. "It may be an evolutionary relic from the Stone Age when they were more important in bringing up children, but even so, as medical care improves women still do better [when it should be levelling off]."

Fortunately, one myth we can scotch is the patronising suggestion that men aren't sufficiently responsible at addressing their own health problems. "When it comes to presenting symptoms, especially around cancer, there's no evidence to suggest that men visit their GPs any less than women," says Martin Tod from the Men's Health Forum. "The big gender difference is actually in preventative care; the stage before that. Women are invited into health centres far more frequently than men because of pregnancy and contraception issues, so there's already that open dialogue."
Men working full-time doesn't help either, he adds. Especially working-class men, who are particularly at risk. "Yes, women go to the doctors more during their working lives, but not because they're women – once men retire that difference narrows to the point of vanishing," he adds. "Men are also more likely to be working long hours and be self-employed, which means that if they don't work they don't get paid. That's not an incentive [to visit their doctor]."
Worryingly, this bleak picture gets even worse when you realise that, arguably, men are less of a priority for healthcare professionals. The secret reason? Politics. "I became a consultant in 1979, the same year that Margaret Thatcher introduced a nationwide breast-screening programme," says Prof Sikora. "The evidence that this would be effective was very weak but, aware that most floating voters are women, Mrs Thatcher and her advisers pressed ahead regardless.  Since then, the screening programme has saved many women. But it has come at phenomenal cost – equivalent to around £1 million per life saved.  Of course, every one of those saved lives is wonderful news, but by treating the NHS as a political football, politicians have added hugely to the disparity between male and female cancer survival rates." 

One look at how this translates into financial reality says it all. A recent report by the Bureau of Investigative Journalism found that "in almost two-thirds of London's wards the life expectancy gap is wider than the national average". Yet, between 2007-2012, NHS Primary Care Trusts in four of the capital's boroughs spent a whopping £4,830,095 on commissioning women's services, but virtually nothing on men's. In the city's more deprived parts the gap stretches to 12 years.
Ironically, charities such as Cancer Research – which flags up these issues – still ban men and boys from some of their annual fundraisers. Its women-only Race for Life event raises money for research into all 200 types of cancer, but bars men from taking part, despite the fact we are three times more likely to get liver cancer, six times more likely to develop bowel cancer, 58 times more likely to be diagnosed with brain cancer, and 27 per cent more likely to get pancreatic cancer.
"Yes, historically, there has been more focus on women, even though the outcome is worse for men," says Sara Hiom, Director of Early Diagnosis and Cancer Intelligence at the Cancer Research UK. "Fortunately, the bowel cancer screening programme is the first national initiative to involve men, so that – along with a growing culture of fitness - might be the start of something bigger," she offers. "Education is also key."

So might Bowie, Rickman and Lemmy have lived a while longer if men had better cancer services?
"The problem with the cancers Bowie and Rickman died of is that there isn't a screening programme for them," says Martin Tod. "There are also big doubts over the effectiveness of tests for prostate cancer, which killed Lemmy. This is all proof that the Department of Health have programmes which clearly aren't working with men. 
"Fortunately," adds Tod, "what we have seen working is governments putting a men's health policy in place, such as in Australia, Ireland and Brazil. These force the powers-that-be to address the inequalities and identify what interventions are needed.
"This year the Chief Medical Officer, Sally Davies, penned her report about women's health. Next year we want her to do the same about men – with special attention paid to cancer."

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