Non-Hispanic Black men have the worst colorectal cancer survival rates of any demographic group, and they are less likely than their non-Hispanic White counterparts to get screened. 

Researchers are working to understand all of the variables contributing to this disparity so organizations like the Colorectal Cancer Alliance can build programs and interventions that increase screening and save lives. 

A new study of more than 300 Black men in Minnesota, Ohio, and Utah provides evidence that greater masculinity barriers to medical care are associated with decreased intent and uptake of screening.

Researchers have long hypothesized that male beliefs about masculinity -- including “being strong,” self-reliance, and preserving heterosexual authority -- may contribute to lower screening rates. These are further complicated by racism and attitudes about screening.  

The paper, which Alliance CEO Michael Sapienza co-authored, explains that:

• Social support and age were positively associated with CRC screening intention.
• Increased knowledge about CRC screening and chronological age was associated with a greater likelihood of completing a stool-based CRC screening test.
• Fewer masculinity and CRC screening barriers were associated with a greater likelihood of undergoing sigmoidoscopy or colonoscopy. 

The study also shows that, among participants, being married reduced screening intention. On this point, the study runs contrary to previous research. The authors note that finding may relate to COVID-19 stressors in play when the data were collected and merits further investigation.

Screening is the No. 1 way to prevent colorectal cancer or catch it early, when it’s most treatable. The study is valuable for informing interventions and health promotion studies focused on increasing rates of screening among Black men. However, the authors note the study’s limitations should be considered. 

This research was led by Alliance health equity consultant Dr. Charles Rogers, an assistant professor at the University of Utah School of Medicine.

Access the manuscript here.