Abstract
Disparities in colorectal cancer (CRC) mortality among White, Black, and American Indian/Alaska Native (AIAN) men are attributable to differences in early detection screening. Determining how masculinity barriers influence CRC screening completion is critical for cancer prevention and control. To determine whether masculinity barriers to medical care are associated with lower rates of ever completing CRC screening, a survey-based study was employed from December 2020–January 2021 among 435 White, Black, and AIAN men (aged 45–75) who resided in the US. Logistic regression models were fit to four Masculinity Barriers to Medical Care subscales predicting ever completing CRC screening. For all men, being strong was associated with 54% decreased odds of CRC screening completion (OR 0.46, 95% CI 0.23 to 0.94); each unit increase in negative attitudes toward medical professionals and exams decreased the odds of ever completing CRC screening by 57% (OR 0.43, 95% CI 0.21 to 0.86). Black men who scored higher on negativity toward medical professionals and exams had decreased odds of ever screening. Consideration of masculinity in future population-based and intervention research is critical for increasing men’s participation in CRC screening, with more salience for Black men.
Highlights
Since the mid-1990s, colorectal cancer (CRC) incidence and mortality have declined significantly in adults aged 50 years and older [1–3], but increased among those under age 50 (early-onset CRC (EOCRC))
CRC mortality is largely preventable with regular screening, yet American Indian/Alaska
The decreased odds associated with negative attitudes were more prevalent among Black men but not among American Indian/Alaska Native (AIAN) men
Summary
Since the mid-1990s, colorectal cancer (CRC) incidence and mortality have declined significantly in adults aged 50 years and older [1–3], but increased among those under age 50 (early-onset CRC (EOCRC)). By 2030, EOCRC incidence is predicted to increase by. Of an estimated 147,950 new CRC cases diagnosed in 2020, 12% occurred among individuals aged under 50 years [1,2]. CRC mortality is largely preventable with regular screening, yet American Indian/Alaska. Native (AIAN) and Black men [2,4–9] in the US continue to experience higher CRC incidence and mortality than their White male counterparts [1,5,7,10]. CRC incidence [10] and 36% to 47% higher mortality in Black men than in White men [2,10]. For AIAN men, incidence and mortality are approximately 4% and 3% higher than for
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