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Gender differences in cancer mortality risk perceptions and screening behaviors among adults 40-60 years of age.



The purpose of this study was to examine gender differences in cancer mortality risk perceptions and preventive screening behaviors as well as perceptions of gender differences in types of cancer risks. A telephone survey was administered to 300 men and 300 women between 40 and 60 years of age, all of whom were contacted via a random digit dialing Random digit dialing (RDD) is a method for selecting people for involvement in telephone statistical surveys by generating telephone numbers at random. Random digit dialing has the advantage that it includes unlisted numbers that would be missed if the numbers were selected from a  procedure. Findings showed that 62% of respondents believed that prostate cancer prostate cancer, cancer originating in the prostate gland. Prostate cancer is the leading malignancy in men in the United States and is second only to lung cancer as a cause of cancer death in men.  was the most frequent cause of cancer mortality among men (12% actual) while breast cancer was thought to be the most frequent cause reported among 80% of women (17% actual). It was determined that 79% of men and women are discussing or receiving preventive screening for prostate prostate /pros·tate/ (pros´tat) a gland surrounding the bladder neck and urethra in the male; it contributes a secretion to the semen.prostat´ic

pros·tate
n.
The prostate gland.

adj.
 and breast cancer, respectively, and that these frequencies increase significantly after age 50. Finally, most respondents believed that women had higher rates of cancer morbidity and mortality Morbidity and Mortality can refer to:
  • Morbidity & Mortality, a term used in medicine
  • Morbidity and Mortality Weekly Report, a medical publication
See also
  • Morbidity, a medical term
  • Mortality, a medical term
 than men. These results suggest that an increase in cancer mortality risk awareness is needed among both men and women. The elevated risks among men need to be made salient, and prevention campaigns that target men's mortality risks need to be developed.

Keywords: gender differences, cancer mortality, risk perceptions, prostate cancer, breast cancer, screening behaviors

**********

Cancer is currently a leading cause of death among Canadians. According to according to
prep.
1. As stated or indicated by; on the authority of: according to historians.

2. In keeping with: according to instructions.

3.
 the National Cancer Institute of Canada (NCIC NCIC National Crime Information Center
NCIC National Cancer Institute of Canada
NCIC North Carolina Industrial Commission
NCIC National Cartographic Information Center
NCIC National Cancer Information Center (American Cancer Society) 
), the 2004 age-standardized incidence rates for cancer were 449 per 100,000 men and 351 per 100,000 women (NCIC, 2004). The most frequently diagnosed cancer for men was prostate cancer (121/100,000) while the most frequently diagnosed cancer for women was breast cancer (106/100,000). The average treatment success rate for both of these cancer types is high. As a result, for both males and females the most frequent cause of death from cancer was lung cancer lung cancer, cancer that originates in the tissues of the lungs. Lung cancer is the leading cause of cancer death in the United States in both men and women. Like other cancers, lung cancer occurs after repeated insults to the genetic material of the cell.  (65/100,000 for men; 40/100,000 for women). The mortality rates for prostate and breast cancers were close to half these estimates (27/100,000 and 24/100,000, respectively).

The NCIC statistics also show that, once women's greater longevity longevity (lŏnjĕv`ĭtē), term denoting the length or duration of the life of an animal or plant, often used to indicate an unusually long life.  is taken into account, men are not only more likely to get cancer, but they are also more likely to die from it. That is, men are 28% more likely than women to be diagnosed with cancer, but of those diagnosed, men are 47% more likely than women to die from cancer (NCIC, 2004). These gender differences in morbidity and mortality have been stable since at least 1969 (NCIC, 1998).

Although lung cancer is the leading cancer-related cause of death in Canada, most media and research attention is devoted to breast cancer and, more recently, prostate cancer. Given the widespread focus on these two types of cancer, social science theories of media influence such as the Cultivation Hypothesis (Gerbner, Gross, Morgan, & Signorielli, 1994; McCreary, 1997; McCreary & Sadava, 1999) predict that people should overestimate o·ver·es·ti·mate  
tr.v. o·ver·es·ti·mat·ed, o·ver·es·ti·mat·ing, o·ver·es·ti·mates
1. To estimate too highly.

2. To esteem too greatly.
 men's likelihood of dying from prostate cancer and women's likelihood of dying from breast cancer. Furthermore, because the media focus on prostate cancer is relatively new and also because there has been a relative absence of men in the social marketing campaigns for cancer prevention, these theories also predict that people will believe women are at greater risk than men for being diagnosed with cancer and experiencing a cancer-related death.

Early detection is seen as important for reducing cancer mortality. The two keystones to ensuring early detection are awareness and screening. This is especially important for middle-aged men and women, since this is the time when risk increases and, consequently, most will begin to submit to more extensive screening by their physicians (Feightner, 1994; Morrison, 1994). However, there are differing opinions about when preventive screening should begin. The Canadian Task Force on Preventive Health Care (CTFPHC CTFPHC Canadian Task Force on Preventive Health Care ) does not recommend regular, preventive prostate cancer screening Prostate cancer screening is an attempt to identify individuals with prostate cancer in a broad segment of the population—those for whom there is no reason to suspect prostate cancer.  (Feightner, 1994) because the scientific evidence has not been compelling enough (e.g., Meyer & Fradet, 1999; Partin & Wilt, 2002). On the other hand, the Canadian Cancer Society The Canadian Cancer Society is a volunteer-based organization which seeks to eradicate cancer and to enhance the quality of life of those suffering from it.

The Society
 (2004a) recommends that men begin discussing prostate cancer screening with their physicians beginning at age 50. For women, the Canadian Cancer Society recommends regular breast self-examination Breast Self-Examination Definition

A breast self-examination (BSE) is an inspection by a woman of her breasts to detect breast cancer.
Purpose
 (BSE See Bombay Stock Exchange.

BSE

See Boston Stock Exchange (BSE).
) from age 20 onward on·ward  
adj.
Moving or tending forward.

adv. also on·wards
In a direction or toward a position that is ahead in space or time; forward.
, discussing mammograms with their physicians at age 40, and undergoing mammography mammography, diagnostic procedure that uses low-dose X rays to detect abnormalities in the breasts. The early diagnosis of breast cancer made possible by the routine use of mammography for screening women increases a woman's treatment alternatives and improves her  every two years beginning at 50 (Canadian Cancer Society, 2004b). The recommendations from the CTFPHC are almost identical to the Canadian Cancer Society policy, with one exception: the CTFPHC notes that the scientific evidence suggests that BSE is not effective and, therefore, does not promote its use (Morrison, 1994).

Awareness of cancer risk should lead to an increased focus on screening, including either actual physical tests or discussions with a physician about the practicality of screening. Because of the focussed media attention on prostate and breast cancers, both men and women are likely to be actively engaged with their physicians in either talking about screening or being screened. Similarly, because physician guidelines guidelines,
n.pl a set of standards, criteria, or specifications to be used or followed in the performance of certain tasks.
 (i.e., CTFPHC) and patient information sources such as the Canadian Cancer Society both recommend screening after 50, there should be an increase in screening or screening discussions after this age.

The purpose of this study was to explore cancer risk perceptions, perceptions of gender differences in cancer risks, and prostate and breast cancer screening This article or section recently underwent a major revision or rewrite and needs further review. You can help! X-ray mammography
Mammography is still the modality of choice for screening of early breast cancer, since it is relatively fast, reasonably accurate, and
 behaviour in men and women between 40 and 60 years of age. We explored four related hypotheses. (1) When asked the type of cancer from which men and women are most likely to die, respondents will overestimate men's likelihood of dying from prostate cancer and women's likelihood of dying from breast cancer. (2) Many men and women will have discussed prostate or breast cancer screening with their physicians, although this number should be higher in those over 50 years old. (3) When asked which gender is at greater risk for being diagnosed with and dying from cancer, respondents will be more likely to say that women are at greater risk. (4) When asked whether women are more likely to die from breast cancer than men die from prostate cancer, participants will be more likely to agree with this statement.

METHODS

PROCEDURE

A national survey organization conducted 600 telephone interviews during June and July of 2003. All respondents were contacted via a random digit dialling procedure. If the person who answered the telephone was not between 40 and 60 years of age, he/she was asked whether there was anyone in the household in that age group. Most interviews (70%) were conducted after 5 p.m. The interviews were conducted using a Computer-Assisted Telephone Interview (CATI CATI Computer-Assisted Telephone Interviewing
CATI California Agricultural Technology Institute
CATI Center for Advanced Technology & Innovation
CATI Carolina Association of Translators & Interpreters
) system and took between four and 19 minutes to complete (M = 7.63, SD = 1.88). The completed interviews represent a 43% response rate (i.e., 1390 valid contacts, 790 refusals).

PARTICIPANTS

All respondents (300 men and 300 women) were Ontario residents, between 40 and 60 years of age. Twelve percent of respondents lived in the Greater Toronto Area The Greater Toronto Area (widely abbreviated as the GTA) is the most populous metropolitan area in Canada. The GTA is a provincial planning area with a population of 5,555,912 at the 2006 Canadian Census.  (GTA GTA Grand Theft Auto (legal)
GTA Grand Theft Auto (video game)
GTA Greater Toronto Area (Canada)
GTA Graduate Teaching Assistant
), 24% lived in the more suburban outer GTA, 27% resided in other areas of Southern Ontario, 16% lived in Eastern Ontario Eastern Ontario is the region of the Canadian province of Ontario which lies in a wedge-shaped area between the Ottawa and St. Lawrence Rivers. It shares water boundaries with Quebec, to the north and New York State to south.

Population: 1,392,346 (2001), est.
, 18% resided in Central Ontario Central Ontario is the portion of the Canadian province of Ontario which lies between Georgian Bay and the eastern end of Lake Ontario.

The population of the region was 959,266 in 2001; however, this number does not include large numbers of seasonal residents, which at peak
, and 3% lived in Western Ontario. A more detailed description of the sample is provided in Table 1. Gender differences in these characteristics were examined using [chi square chi square (kī),
n a nonparametric statistic used with discrete data in the form of frequency count (nominal data) or percentages or proportions that can be reduced to frequencies.
] tests. No significant gender differences emerged for age or marital status marital status,
n the legal standing of a person in regard to his or her marriage state.
. With regard to employment status, men were more likely to be employed full-time, while women were more likely to be employed part-time, [chi square] (5, n = 599) = 51.91, p < .001. Weight status differed significantly as a function of gender, [chi square] (3, n = 585) = 26.33, p < .001, such that women were more likely to be at normal weight while men were more likely to be overweight Overweight

Refers to an investment position that is larger than the generally accepted benchmark.

Notes:
For example, if a company normally holds a portfolio whose weighting of cash is 10%, and then increases cash holdings to 15%, the portfolio would have an overweight
 or obese o·bese
adj.
Extremely fat; very overweight.



obese

characterized by obesity.

obese adjective Characterized by obesity, see there; excessively fat
. There also was a significant gender difference in perceived health, [chi square] (2, n = 599) = 6.29, p < .04. Men and women were fairly equally represented in the poor/fair health or very good/excellent health categories, while more men than women rated their health as "good."

TELEPHONE INTERVIEWING TECHNIQUE

The following questions were used to assess cancer perceptions and awareness as well as screening behaviors. All questions were read to respondents in the same manner, using the CATI system to provide the script and prompts.

Cancer Mortality Perceptions. Respondents were asked to indicate (1) which type of cancer causes the most deaths among men and (2) which type of cancer causes the most deaths among women. For both questions, no prompts were given.

Prostate and Breast Cancer Screening Behaviors. To determine the extent to which men and women are engaged with their family physician in screening for prostate and breast cancers, two questions were posed. For men, we asked: "Have you ever been screened for prostate cancer or discussed prostate screening with a doctor?" For women, we asked: "Have you ever had a mammogram mammogram /mam·mo·gram/ (mam´o-gram) a radiograph of the breast.

mam·mo·gram
n.
An x-ray image of the breast produced by mammography.
 or discussed mammograms with a doctor?" For both questions, a yes or no response was solicited.

Perceived Gender Differences in Cancer Morbidity and Mortality. Respondents were asked to rate their level of agreement with the following three questions about gender differences in cancer mortality risks. (1) More men are diagnosed with cancer than are women. (2) Men who are diagnosed with cancer are less likely than women to die within five years. (3) More Canadian women are diagnosed with breast cancer than men are diagnosed with prostate cancer. (The first question is true, while the second and third questions are false [NCIC, 2003].) Responses to each question were made on a five-point Likert scale Likert scale A subjective scoring system that allows a person being surveyed to quantify likes and preferences on a 5-point scale, with 1 being the least important, relevant, interesting, most ho-hum, or other, and 5 being most excellent, yeehah important, etc , ranging from strongly disagree (1) to strongly agree (5).

RESULTS

CANCER MORTALITY PERCEPTIONS

Responses to the questions asking about the type of cancer that Canadian men and women were most likely to die from can be found in Table 2. Respondents gave a wide range of responses that included nine different cancer types for men and seven different cancer types for women. However, as Table 2 shows, both men and women overestimated the frequency with which men die of prostate cancer and women die of breast cancer. Overall, 62% of respondents believed that men's greatest cancer mortality risk came from prostate cancer. However, for the year in which the survey was completed, prostate cancer was ranked third in men's cancer mortality (after lung and colorectal cancers colorectal cancer

Malignant tumour of the large intestine (colon) or rectum. Risk factors include age (after age 50), family history of colorectal cancer, chronic inflammatory bowel diseases, benign polyps, physical inactivity, and a diet high in fat.
), and represented only 12% of men's cancer deaths (NCIC, 2003). A similar pattern of findings emerged for breast cancer: 80% of respondents believed that breast cancer was the most frequent cancer-related cause of mortality for women, whereas it was ranked second in the 2003 statistics (after lung cancer) and represented only 17% of women's cancer deaths.

As a supplemental question, we sought to determine whether men and women differed in their overestimation o·ver·es·ti·mate  
tr.v. o·ver·es·ti·mat·ed, o·ver·es·ti·mat·ing, o·ver·es·ti·mates
1. To estimate too highly.

2. To esteem too greatly.
 of men's risk of dying from prostate cancer and women's risk of dying from breast cancer. Because of the free-response nature of the two questions asked here, we created a two-category proxy variable for each. For the men's mortality question, the two categories were prostate cancer and other cancer. For the women's mortality question, the two categories were breast cancer and other cancer. Two 2 (Gender) x 2 (Cancer Category) chi-square analyses were then conducted. For perceptions of men's cancer mortality, women (58%) were significantly more likely than men (42%) to believe that prostate cancer was the leading cause of men's cancer-related mortality, [chi square] (1, n = 572) = 22.62, p < .001. There were no significant gender differences in respondents' estimates of women's likelihood of dying from breast cancer (Men = 51%, Women = 49%; p > .05).

SCREENING BEHAVIOURS

Overall, 65% of men noted that they either had discussed prostate cancer screening with their physician or had undergone screening for prostate cancer. Seventy-nine percent of women reported that they had either discussed having a mammogram with their physicians or had received a mammogram. In order to compare men's and women's screening behaviours, we collapsed the responses to these two questions and conducted a chi-square goodness of fit Goodness of fit means how well a statistical model fits a set of observations. Measures of goodness of fit typically summarize the discrepancy between observed values and the values expected under the model in question. Such measures can be used in statistical hypothesis testing, e.  test. The findings showed that women were significantly more likely to have discussed or undergone breast cancer screening than men were to have discussed or undergone prostate cancer screening, [chi square] (1, n = 595) = 15.59, p < .001. Because of the importance of age 50 in the Canadian Cancer Society screening guidelines, two chi-square goodness of fit tests were used to determine whether (1) more men over 50 were discussing or undergoing screening for prostate cancer, compared to men under 50, and (2) more women over 50 were discussing or undergoing screening for breast cancer (i.e., mammograms), compared to women under 50. For men under 50, 49% had discussed or experienced prostate screening with their physician; for those 50 and older, however, the number was significantly higher (80%), [chi square] (1, n = 297) = 29.53, p < .001. For women under 50, 68% had discussed or undergone mammography, while for women 50 and older, 92% had clone clone, group of organisms, all of which are descended from a single individual through asexual reproduction, as in a pure cell culture of bacteria. Except for changes in the hereditary material that come about by mutation, all members of a clone are genetically  so, [chi square] (1, n = 298) = 26.28, p < .001.

PERCEIVED GENDER DIFFERENCES IN CANCER RISK

For each of the three questions asked about perceived gender differences in cancer morbidity and mortality, we felt that collapsing the five-level responses into three categories (Strongly Agree/Agree, Neither Agree Nor Disagree, Disagree/Strongly Disagree) and analysing the data using chi-square analyses was more meaningful than exploring mean differences in responses. In other words Adv. 1. in other words - otherwise stated; "in other words, we are broke"
put differently
, because each of the statements is empirically either true or false, we wanted to know the degree to which the respondents agreed with the one true statement and disagreed with the two untrue un·true  
adj. un·tru·er, un·tru·est
1. Contrary to fact; false.

2. Deviating from a standard; not straight, even, level, or exact.

3. Disloyal; unfaithful.
 statements as well as whether male and female respondents differed in their agreement. The rates of agreement and disagreement to each question can be found in Table 3.

For the item asking whether men are more likely than women to be diagnosed with cancer, a chi-square goodness of fit test showed that a significantly greater number of the respondents disagreed with this true statement than would be expected by chance alone, [chi square] (2, n = 565) = 100.15, p < .001. When we explored gender differences in responses to this statement using a 2 (Gender) x 3 (Agreement Categories) chi-square test chi-square test: see statistics. , we observed that women were significantly more likely than men to disagree with Verb 1. disagree with - not be very easily digestible; "Spicy food disagrees with some people"
hurt - give trouble or pain to; "This exercise will hurt your back"
 this true statement, [chi square] (2, n = 565) = 10.89, p < .01. For the statement that men who are diagnosed with cancer are more likely than women to survive the first five years of their cancer, a significantly greater number of the respondents disagreed with this false statement than would be expected by chance alone, [chi square] (2, n = 568) = 42.01, p < .001. Men and women did not differ significantly in their responses to this statement (p > .05). The third statement asked respondents whether they agreed with the statement that more women are diagnosed with breast cancer than men with prostate cancer. Significantly more respondents agreed with this false statement than would be expected by chance alone, [chi square] (2, n = 566) = 226.24, p < .001. There were no significant gender differences in responses to this item (p > .05).

DISCUSSION

The findings from the present study support our four cultivation hypothesis-derived research questions regarding cancer-related risk misperceptions in middle-aged men and women. The first two hypotheses stem from the wide-ranging media attention devoted to breast cancer among women and prostate cancer among men. Our first prediction, that men and women would overestimate men's likelihood of dying from prostate cancer and women's likelihood of dying from breast cancer, was supported. Sixty-two percent of our respondents thought that prostate cancer was the leading type of cancer death among men, while 80% of respondents thought that breast cancer was the leading cancer-related cause of death among women. However, in 2003, this was not the case. Prostate cancer accounted for only 12% of men's cancer deaths, and breast cancer accounted for only 17% of women's cancer deaths (NCIC, 2003).

Our second prediction was that men and women would be discussing or have had their physicians conduct prostate screening or mammography, and that a greater percentage of men and women should be doing so after age 50. These predictions were supported. However, what serves as evidence for the greater salience sa·li·ence   also sa·li·en·cy
n. pl. sa·li·en·ces also sa·li·en·cies
1. The quality or condition of being salient.

2. A pronounced feature or part; a highlight.

Noun 1.
 of these types of cancer in men's and women's minds is the finding that 49% of men under 50 and 68% of women under 50 have either discussed screening with their physician or have undergone a screening procedure. The figures for men are even more surprising since there is medical uncertainty about the usefulness of prostate cancer screening (Meyer & Fradet, 1999). Thus, while we would expect a certain percentage of men and women to be discussing or undergoing screening, the numbers seem exceptionally high and suggest that the social salience In social psychology is a set of reasons which cause observer to draw his attention toward some object. The reasons for this effect can be:-

1. General object attributes - vivid colors, stands right in front of observer etc

2.
 of these two types of cancer may be associated with this extra degree of vigilance VIGILANCE. Proper attention in proper time.
     2. The law requires a man who has a claim to enforce it in proper time, while the adverse party has it in his power to defend himself; and if by his neglect to do so, he cannot afterwards establish such claim, the
.

Our second set of hypotheses, which addressed perceptions of gender differences in cancer risk, were supported. That is, respondents did not know that men are more likely than women to suffer from cancer. They also were more likely to believe, inaccurately, that breast cancer incidence is more prevalent among women than prostate cancer is among men. Their responses to the question about men's and women's five-year cancer mortality were somewhat more accurate. However, there is the possibility that these findings were a result of the awkward wording of the statement. Therefore, future research needs to reexamine re·ex·am·ine also re-ex·am·ine  
tr.v. re·ex·am·ined, re·ex·am·in·ing, re·ex·am·ines
1. To examine again or anew; review.

2. Law To question (a witness) again after cross-examination.
 people's beliefs about men's and women's cancer mortality.

In addition to the hypothesized findings, the gender differences we observed in these misperceptions also are notable. That is, women were more likely to overestimate men's prostate cancer mortality risks but minimize men's overall rates of prevalence. Given that women are often the gatekeepers for men's health-protective behaviours (including scheduling physician appointments and screenings) (Courtney, 2003; International Longevity Center--USA Interdisciplinary in·ter·dis·ci·pli·nar·y  
adj.
Of, relating to, or involving two or more academic disciplines that are usually considered distinct.


interdisciplinary
Adjective
 Workshop Group, 2004; Meryn & Jadad, 2001), this gender difference may contribute to men's greater focus on prostate cancer risks than on risks from other cancer types.

To what extent do the cancer misperceptions reported in this study have relevance for the real world of cancer care? First, with regard to the finding that most men and women are discussing prostate and breast cancer screening with their physicians, an important point to consider is whether this discussion is being initiated by the respondents themselves or by their physicians. If the conversations are not being initiated by the physicians, then the question of patient motivation becomes important. For example, are people asking their physicians about screening because they have an inflated idea about their personal risk for having the disease as well as from dying from it (i.e., confusing morbidity morbidity /mor·bid·i·ty/ (mor-bid´it-e)
1. a diseased condition or state.

2. the incidence or prevalence of a disease or of all diseases in a population.


mor·bid·i·ty
n.
 with mortality)? This is especially important for women, who, in addition to having an elevated perception of their risk of dying from cancer, also appear to underestimate their risk of dying from cardiovascular disease Cardiovascular disease
Disease that affects the heart and blood vessels.

Mentioned in: Lipoproteins Test

cardiovascular disease 
, even though it is the leading cause of death among North American North American

named after North America.


North American blastomycosis
see North American blastomycosis.

North American cattle tick
see boophilusannulatus.
 women (Grace, Fry, Cheung, & Stewart, 2004; Mosca et al., 2001).

Patient motivation aside, however, women are still being screened at significantly higher rates than men. The extent to which this is a function of the CTFPHC physician screening guidelines or men's typically low levels of healthcare involvement (Courtney, 2003) needs to be determined.

Our findings also suggest that further investigation into current Canadian cancer research and services is warranted. A cursory cur·so·ry  
adj.
Performed with haste and scant attention to detail: a cursory glance at the headlines.



[Late Latin curs
 glance shows that funding for breast cancer research, prevention, or support programs far outstrips those provided for any other type of cancer. Next in line for attention (although still small in comparison, but growing) has been prostate cancer. Other questions that need to be asked include, but are not limited to, the following: Why are gender-specific cancers like breast and prostate receiving more interest than other common cancers while, at the same time, there has there been so little concentrated focus on lung, colorectal co·lo·rec·tal
adj.
Relating to the colon and the rectum, or to the entire large bowel.



colorectal

pertaining to or of the nature of the colon and the rectum.
, or pancreatic cancers pancreatic cancer

Malignant tumour of the pancreas. Risk factors include smoking, a diet high in fat, exposure to certain industrial products, and diseases such as diabetes and chronic pancreatitis. Pancreatic cancer is more common in men.
? Why is there more attention to women's cancers than to men's, and could this be related to factors such as age-at-diagnosis and women's parenting roles at this life stage? Is health care policy and spending being influenced primarily by human need, or are we acting on widely shared misperceptions, fuelled by strong special interest advocacy, successful marketing strategies, and gender politics? Finally, what are the implications of our findings for other heath care systems in other parts of the Westernized west·ern·ize  
tr.v. west·ern·ized, west·ern·iz·ing, west·ern·iz·es
To convert to the customs of Western civilization.



west
 world. Answers to these questions have important implications for all levels of the Canadian health care system.

REFERENCES

The Canadian Cancer Society. (2004a). Early detection and screening for prostate cancer. Retrieved November 19, 2004, from http://www.cancer.ca/ccs/internet/standard/0,3182,3172_10175_74550606_langId- en,00.html.

The Canadian Cancer Society. (2004b). Early detection and screening for breast cancer. Retrieved November 19, 2004, from http://www.cancer.ca/ccs/internet/standard/0,3182,3172_10175_74544430_langId- en,00.html.

Courtney, W.H. (2003). Key determinants of the health and well-being of men and boys. International Journal of Men's Health Men's Health Definition

Men's health is concerned with identifying, preventing, and treating conditions that are most common or specific to men.
, 2, 1-30.

Feightner, J.W. (1994). Screening for prostate cancer: Summary table of recommendations. Canadian Task Force on Preventive Health Care. Retrieved November 19, 2004, from http://www.ctfphc.org/Tables/Ch67tab.htm.

Gerbner, G., Gross, L., Morgan, M., & Signorielli, N. (1994). Growing up with television: The cultivation perspective. In J. Bryant & D. Zillmann (Eds.), Media effects: Advances in theory and research (pp. 17-41). Hillsdale, NJ: Lawrence Erlbaum.

Grace, S.L., Fry, R., Cheung, A., & Stewart, D.E. (2004). Cardiovascular disease. BMC (BMC Software, Inc., Houston, TX, www.bmc.com) A leading supplier of software that supports and improves the availability, performance, and recovery of applications in complex computing environments.  Women's Health Women's Health Definition

Women's health is the effect of gender on disease and health that encompasses a broad range of biological and psychosocial issues.
, 4 (Suppl 1), S15.

International Longevity Center Organized in 1990 by Robert N. Butler, M.D., Professor of Geriatrics at Mount Sinai School of Medicine, The International Longevity Center-USA (ILC-USA) is a not-for-profit, nonpartisan research, policy and education organization whose mission is to help societies address the issues of , USA Interdisciplinary Workshop Group (2004). Promoting men's health: Addressing barriers to healthy lifestyle and preventive health care. International Longevity Center--Canyon Ranch Series, No. 9. July.

McCreary, D.R., & Sadava, S.W. (1999). TV-viewing and self-perceived health, weight, and physical fitness: Evidence for the cultivation hypothesis. Journal of Applied Social Psychology, 29, 2342-2361.

Meyer, F., & Fradet, Y. (1999). Screening. In N.A. Iscoe & M.A. Jewett (Eds.). Prostate cancer: Balancing the risks in diagnosis and treatment (pp. 35-42). Ottawa: Canadian Medical Association The Canadian Medical Association (CMA), with more than 65,000 members, is the largest association of doctors in Canada and works to represent their interests nationally. It formed in 1867, three months after Confederation. .

Meryn, S., & Jadad, A.R. (2001). The future of men and their health: Are men in danger of extinction extinction, in biology, disappearance of species of living organisms. Extinction occurs as a result of changed conditions to which the species is not suited. ? British Medical Journal The British Medical Journal, or BMJ, is one of the most popular and widely-read peer-reviewed general medical journals in the world.[2] It is published by the BMJ Publishing Group Ltd (owned by the British Medical Association), whose other , 323, 1013-1014.

Morrison, B.J. (1994). Screening for breast cancer: Summary table of recommendations [database on the Internet]. Canadian Task Force on Preventive Health Care. Retrieved November 19, 2004, from http://www.ctfphc.org/Tables/Ch65tab.htm.

Mosca, L., Ferris, A., Fabunmi, R., Robertson, R.M., & American Heart Association American Heart Association (AHA),
n.pr a national voluntary health agency that has the goal of increasing public and medical awareness of cardiovascular diseases and stroke, and thereby reducing the number of associated deaths and disabilities.
. (2004). Tracking women's awareness of heart disease: An American Heart Association national study. Circulation, 109, 573-479.

National Cancer Institute of Canada. (1998). Canadian cancer statistics. Toronto, Canada.

National Cancer Institute of Canada. (2003). Canadian cancer statistics. Toronto, Canada.

National Cancer Institute of Canada. (2004). Canadian cancer statistics. Toronto, Canada.

Partin, M.R., & Wilt, T.J. (2002). Informing patients about prostate cancer screening: Identifying and meeting the challenges while the evidence remains uncertain. American Journal of Medicine, 113, 691-693.

DONALD R. MCCREARY

York University York University, at North York, Ont., Canada; nondenominational; coeducational; founded 1959 as an affiliate of the Univ. of Toronto, became independent 1965.  and Brock University Brock University, at St. Catharines, Ont., Canada; coeducational; founded 1964. It has faculties of humanities, social science, science and mathematics, education, business, and physical education and recreation.

York, Ontario
''This article is about the former City of York in Toronto. For the regional municipality immediately north of Toronto, see York Regional Municipality, Ontario. The city of Toronto itself was historically named York.
, Canada

Ross E. GRAY

Sunnybrook & Women's Health Sciences Centre

Toronto, Ontario, Canada

SHERRY L. GRACE

York University and University Health Network

York, Ontario Canada

The Canadian Cancer Society, Ontario Division, provided funding for the study described in this paper.

Correspondence concerning this article should be directed to Ross Gray, Sunnybrook & Women's Health Sciences Centre, Psychosocial psychosocial /psy·cho·so·cial/ (si?ko-so´shul) pertaining to or involving both psychic and social aspects.

psy·cho·so·cial
adj.
Involving aspects of both social and psychological behavior.
 & Behavioural Adj. 1. behavioural - of or relating to behavior; "behavioral sciences"
behavioral
 Research Unit, 790 Bay St., Suite 950 Toronto, ON Canada M5G 1N8. Electronic mail: Ross.Gray@Sunnybrook.ca.
Table 1
Respondents' Demographic Characteristics
(All values are percentages.)

haracteristics                    Total      Men      Women
                                  N= 600   n = 300   n = 300

Age
40-49                               51       49        53
50-60                               49       51        47

Marital Status
Married or cohabiting               72       72        71
Single, never married               13       13        10
Widowed                             1         1         4
Divorced, separated                 14       14        15

Employment Status
Employed full-time                  65       75        55
Employed part-time                  10        6        14
Retired                             13       13        13
Student                            < 1        0         1
Homemaker                           5         0        11
Not employed for pay                6         6         7

Weight Status
Underweight (BMI < 18.5)            1         1         2
Normal Weight (BMI 18.5-24.9)       36       27        46
Overweight (BMI 25 to 29.9)         39       44        34
Obese (BMI >30)                     24       28        19

Perceived Health
Poor/Fair                           15       14        15
Good                                30       35        25
Very Good/Excellent                 55       51        60

Note: BMI: Body Mass Index.

Table 2
Perceived Most Common Type of Cancer Mortality
(In Percentages) for Men and Women,
as a Function of Respondents' Gender

                           Perceptions of      Perceptions of
                           Men's Risks         Women's Risks

                             Men      Women      Men      Women

Cancer Type n              n = 300   n = 300   n = 300   n = 300
Body of uterus/uterus        --        --        0.7        1
Brain                        --        --        0.3       0.3
Breast                       0.3       --       82.2      77.5
Cervix                       --        --        2.4        2
Colorectal/colon             8.4       8.4       1.4       0.3
Kidney                       0.3       --        --        --
Larynx                       0.3       --        --        --
Lung                        34.1      18.2      10.5      11.9
Melanoma/skin                2.4       --        --        --
Multiple myeloma/myeloma     --        --        --        0.3
Oral/mouth                   --        --        --        0.3
Ovary                        --        --        2.4       6.1
Pancreas                     0.3       0.4       --        --
Prostate                    52.3      71.6       --        --
Stomach                      --        0.4       --        --
Testis/Testicle              1.4       1.1       --        --
Thyroid                      --        --        --        --

Table 3
Perceptions of Gender Differences in Cancer Risk as
a Function of Respondents' Gender
(All values are percentages.)

                                    Total      Men      Women
Questions                           N= 600   n = 300   n = 300

1. More men are diagnosed
   with cancer than are women
   Strongly/somewhat disagree         52       46        58
   Neither disagree nor agree         18       52        48
   Somewhat/strongly agree            30       60        40

2. Men who are diagnosed
   with cancer are less
   likely than women to
   die within 5 years
   Strongly/somewhat disagree         45       50        50
   Neither disagree nor agree         24       57        43
   Somewhat/strongly agree            31       46        54

3. More Canadian women are
   diagnosed with breast cancer
   than men are diagnosed with
   prostate cancer
   Strongly/somewhat disagree         20       49        51
   Neither disagree nor agree         17       53        47
   Somewhat/strongly agree            63       49        51
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Author:Grace, Sherry L.
Publication:International Journal of Men's Health
Geographic Code:1CANA
Date:Mar 22, 2006
Words:4272
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