Masculinity and colorectal cancer screening: a cross-sectional study of men attending state fairs in Minnesota and Wisconsin.

Background: Success in community-based interventions addressing colorectal cancer (CRC) disparities among men relies on their active engagement in screening activities, yet traditional masculinity norms may deter men from participating in preventive health behaviors.

Purpose: This cross-sectional study examined the association between masculinity barriers to medical care (MBMC) and CRC-screening intent and behaviors among men aged 18-75, attending state fairs in 2 midwestern states.

Methods: CRC-screening intent was assessed for all participants. Screening participation and current screening status were also examined among men aged 45-75 years (screening-age eligible). Composite scores were calculated overall and for each MBMC subscale, with higher scores indicating a stronger endorsement of traditional masculine ideologies. Multivariable logistic regression was employed, adjusting for confounders.

Results: Our findings highlight a high prevalence of self-reported CRC-screening behaviors among men in our study sample (n = 937), with 78% expressing intentions to obtain screening. Among screening-age eligible men (n = 377), 79% reported having participated in CRC screening, with 72% being up-to-date (UTD) with screening. A strong inverse relationship was observed between CRC-screening intention and behaviors, and the Health Problem Minimization subscale as well as Fear of Being Perceived as Gay subscale. Conversely, higher scores on the Provider Role subscale were associated with higher odds of having ever participated in CRC screening, and of being UTD with screening.

Conclusions: Addressing masculinity-related barriers, particularly Health Problem Minimization, could help increase CRC screening uptake among men. Future intervention strategies should consider reframing CRC screening as an act of self-care and strength, emphasizing health empowerment rather than aligning solely with traditional masculine or provider-role ideologies, which may themselves present limitations. By promoting a broader and more inclusive view of masculinity, interventions can better engage men in preventive health behaviors and ultimately improve CRC-screening adherence and outcomes.