Colorectal cancer – applying a gender lens

Oberoi, Devesh V MBBS
Jiwa, Moyez MA MD FRACGP FRCP
McManus, Alexandra MPH PhD PGDipPH B ScHP (H.Biol)
Hodder, Rupert MBChB MD FRCS FRACS

PhD Candidate
Professor
Professor
Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
Consultant Surgeon
Department of General Surgery, Sir Charles Gairdner Hospital, Nedlands, WA, Australia

PEER REVIEW

Not commissioned; externally peer reviewed.

CONFLICTS OF INTEREST

None.

ADDRESS FOR CORRESPONDENCE

Devesh V Oberoi, Curtin University, 7 Parker Place, Bentley, WA 6102, Australia. Tel: +61 08 9266 9582; fax: +61 08 9266 2508; email: [email protected]

Received 17 September 2013

Accepted 28 January 2014

The accompanying appendices may be accessed online at www.radcliffehealth.com/shop/quality-primary-care

Quality in Primary Care 22(2):p 71-79, 2014.

Background

Colorectal cancer (CRC) is a major global health problem with survival varying according to stage at diagnosis. The incidence of CRC is much higher in patients with lower bowel symptoms. The symptoms are non-specific and are commonly experienced in the general population. Biological and environmental factors account for the high incidence and poor prognosis of CRC in men.

Objective

To review the behavioural factors influencing patient delay in seeking help for lower bowel symptoms using a gender lens.

Methods

An extensive literature search was performed using various databases including Medline, PubMed, CINAHL Plus, EMBASE and PsycINFO (1993–2013). Various search terms including rectal bleeding, prevalence, colorectal cancer, consultation, help-seeking, gender differences and men were used. A systematic methodology including systematic data extraction and narrative synthesis was applied.

Results

Thirty-two studies were included in the review. All studies except four were quantitative. Although there is some evidence that men delay more compared with women, there has not been any major improvement in the help-seeking behaviour for such symptoms over the past two decades. Several behavioural and demographic factors were associated with low rates of help-seeking.

Conclusion

There are limited studies focusing on men’s help-seeking behaviour for lower bowel symptoms. To facilitate timely help-seeking in men, it is important to understand their patterns of help-seeking for such symptoms. Further research to understand men’s help-seeking behaviour is warranted.