Wrong place wrong gender

Figures recently published by the Office for National Statistics show that the post code lottery is still a major factor in the health of the nation.  From a mass of detailed information we looked at the five-year survival rates for prostate cancer.  The figures show that if one lives in the North Central district of London there is a 75% chance of surviving five years whilst in South Yorkshire the figure drops to 44%..  Devon and Cornwall are also ill served at 52%.

There are many possible reasons for this large disparity.  At one end of the spectrum, the most favoured regions are those where the teaching hospitals are to be found and a higher than average proportion of patients are seen privately.

At the other end, it is known that the socio-economic mix is an important factor.  It is a regrettable fact that cancer survival in adults is generally lower among patients in more deprived groups than those in affluent groups.  The reasons why the large regional differences in survival rates occur have not been definitively established.  The quality of primary care the speed of referral, the quality of treatment services, even the persistence of outmoded practices are all possibilities.

Survival rates in the UK are, taken as a whole, lower than in comparable western European countries, a fact that, at least in part, can be attributed to patients having more advanced disease at the time of diagnosis.

But that is not all the bad news for men. Studies carried out by the Men’s Health Forum have established that, regardless of where you live, men are more likely than women to suffer from the most common forms of cancer affecting both sexes.  Despite these alarming figures, there appears to be an almost complete absence of strategic thinking within the Department of Health about the relationship between cancer and gender.  None of the various national targets relating to cancer makes any mention of the specific need to reduce the incidence of cancer in men.  Consequently there is virtually no planning at either national or local level that takes into account the clear need for policies, programmes or other dedicated forms of action targeted at men.  All the evidence suggest that men think differently from women about their bodies and their health - for example, in relation to what and how they eat and drink; their reasons for smoking; how they respond to health education messages or use health services; and how they act when they become aware of symptoms.

The Men’s Health Forum proposes action at two levels.

Nationally, the Department of Health should take the lead by developing policies that take gender specifically into account.  Locally, Primary Care Trusts should develop targeted, male specific, programmes for the prevention of cancer.  It is in this locally determined provision that the Men’s Health Forum see the greatest potential for improvements to be made.

Meanwhile, for us men there is nothing we can do about our gender and, for most of us, little we can do about where we live.