Men and lung cancer: a review of the barriers and facilitators to male engagement in symptom reporting and screening

Background: Lung cancer is the second most common cancer in UK men and is the leading cause of cancer death in the UK. Cancer prognosis is generally improved with earlier detection, thus men should be aware of symptoms and be willing to seek help for these.

Methods: A literature search was conducted using online databases, and information on lung cancer awareness-raising programmes was pursued via the internet.

Results: Evidence suggests that men are less likely to utilise population-level cancer screening programmes. Lack of awareness of lung cancer symptoms is more prominent amongst UK men than women, and non-specific symptoms may cause further misinterpretation or non-recognition. Men's fear of appearing un-masculine may result in them ignoring symptoms, yet some literature reports no gender difference in patient delay. Stigma attached to lung cancer may also hinder help-seeking behaviour. Factors that facilitate men's cancer awareness and help-seeking include family members’ and female partners’ influence, a close family member suffering with cancer, and health promotion campaigns.

Conclusions: An innovative approach is required to improve men's lung cancer awareness and likelihood to engage in screening. “Push” and “pull” strategies, involving elements such as social marketing, co-production and X-ray efficiency reviews may be of benefit. Focussing campaigns on important changes such as marriage, becoming a father, bereavement or physical impairment may influence men, and it is particularly important not to position men as ignorant or exclude certain groups of men. Lung cancer programmes must utilise in-depth independent evaluation methods to report their failures and successes, rendering results valuable in ongoing developments.