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Cancer

Cancer is the second-leading cause of death among both men and women in the United States. It is estimated that over 1.4 million U.S. men and women are diagnosed with cancer and over 550,000 die from it annually since 2000. According to the American Cancer Society, over 10.7 million Americans are currently living with or have survived cancer, and cancer survivorship continues to increase. While the term cancer describes a biomedical disease process— namely, the uncontrolled growth and spread of abnormal cells—it also conjures a set of social and culturally embedded meanings. Like all illnesses, cancer emerges within a larger social and cultural milieu, and its meanings are culture bound. A great deal has been written about the meanings and metaphors ascribed to cancer in Western culture, including ways cancer has been construed as a “gendered” illness. Throughout much of history, cancer was associated with women and the female body. While biomedical advances since the 19th century have challenged this association in the public imagination—overall, men are actually more likely to both develop and to die from cancer—gender continues to be an important lens through which cancer is understood and treated. We review how gender (among other cultural factors) shapes lay and professional understandings of cancer and, in turn, affects cancer risk and prevention, detection, treatment, and psychological adjustment among affected individuals.

Gender and Ethnicity in Cancer Incidence and Mortality

Although cancer is a leading cause of death and disability for both men and women, important gender differences exist. Whereas women are more likely than men to develop cancer younger (before age 60), men are overall more likely to develop and die from cancer over the course of their lifetimes. In the United States, men have approximately a 1 in 2 lifetime risk of developing cancer; for women, the risk is 1 in 3. Overall, African Americans are more likely to develop and die from cancer than any other U.S. racial/ethnic group. Across ethnic groups, prostate, lung, and col-orectal cancers are the most prevalent cancers among men. Breast, lung, and colorectal cancers are most prevalent among women. Lung cancer is the leading cause of death for both genders, followed by colorectal and prostate cancer among men and breast and colorectal cancer among women. Specific ethnic groups are at higher risk for certain cancers. For example, Asian Americans have a markedly higher incidence of stomach cancer, cervical cancer rates are highest among Latina women, and breast cancers rates are highest among white women.

Sex, Gender, and Cancer Risk

Sex and gender are important determinants of cancer risk and mortality, operating separately and interactively to produce differential risk for men and women. Sex-linked factors are those related to biological differences between men and women, including hormonal and genetic differences. In contrast, gender-linked factors are socioculturally determined, including lifestyle and behavioral factors (e.g., diet, smoking), exposure to carcinogens in the home or workplace, access to medical and support services, and psychological and social responses to cancer risk, diagnosis, and treatment.

Men and Cancer

Men have higher cancer-related morbidity and mortality. However, relatively little is known about the contribution of gender-related social factors to men's risk of or experience with cancer. There is considerable evidence suggesting that men are more likely to engage in behaviors associated with increased cancer risk (e.g., alcohol use, poor diet, tobacco use) and less likely to take part in regular health screenings and preventive care, including routine skin inspections and testicular self-examination. This often results in delayed diagnosis and treatment and sometimes disability or fatality that could have been prevented. For instance, on average, men delay medical evaluation for symptoms of testicular cancer 26 weeks after experiencing symptoms including pain, swelling, and detection of a mass. There is increasing theoretical and empirical evidence to suggest that gender socialization and norms regarding the masculine gender role likely account for some of these gender-related differences and influence men's behaviors associated with cancer risk, medical care utilization, and psychological adjustment.

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