Barriers to access cancer-related services for men in high-income countries: A narrative review looking beyond socioeconomic disadvantages

Introduction

Cancer screening programs are routinely available in high-income countries, but participation rates are low, especially among men. This narrative review aims to identify male-specific access barriers to cancer-related healthcare in high-income countries that offer statutory insurance/subsidized health care.

Methods

We searched PubMed, Science Direct, and Web of Science for peer-reviewed journal articles published within the past 10 years on cancer healthcare access, help-seeking behavior, and men. Step-wise screening of title, abstract, and full text resulted in 23 studies that fit the selection criteria for findings in high-income countries. The results were analyzed descriptively using qualitative thematic synthesis.

Results

In the reviewed studies, barriers for men in accessing cancer-related healthcare offers could be broadly categorized under sociocultural norms, personal behaviors, and structural problems. The most common barriers were related to sociocultural influences and included notions of masculinity, distrust in the medical system, and personnel/social commitments. Major personal barriers included fear of getting cancer or screening methods, lack of awareness about cancer, and problems in communication with healthcare professionals. Accessibility and lack of insurance were reported as common structural barriers.

Conclusions

The reluctance of men in approaching medical help was rooted in sociocultural norms of traditional masculinity with direct and indirect consequences such as fear, lack of awareness, distrust of medical personnel, and problems in communicating with healthcare professionals. Gender-specific, male-oriented information via digital, anonymous interventions may be helpful for increasing participation of men in cancer care.