When Men Are Diagnosed Later,

Are We Asking the Right Question?

*The thoughts and opinions in this article are reserved to the author and do not necessarily reflect that of Men’s Health Network.

Reposted from: Dominick Shattuck, PhD – Jul 21

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A recent study examined more than 2.4 million cancer cases across 30 different types of non-reproductive cancers in the United States. The findings were striking. Compared with women, men were significantly more likely to be diagnosed at a later stage for 20 of the 30 cancers examined. For many cancers, that meant men were more likely to receive a diagnosis after the disease had already spread regionally or to distant parts of the body (Maclin et al., 2026).

Timing matters, as the stage at diagnosis is one of the strongest predictors of survival. In general, cancers found earlier are easier to treat and are associated with better outcomes. If you’ve spent any time reading about men’s health, generalized explanations may feel familiar.

Men don’t like going to the doctor.

Men ignore symptoms.

Masculinity gets in the way of seeking care.

There is certainly some truth in those statements. I’ve advocated for more focus on men’s health behaviors regularly, as research reflects the negative impact of factors like trust and masculine norms, influencing how many men view illness, vulnerability, and help-seeking. But what struck me most about this study wasn’t simply the finding itself. It was what the authors didn’t claim.

Maclin and colleagues stopped short of concluding that masculinity, healthcare avoidance, or delayed help-seeking caused the differences they observed. Instead, they described a much broader set of possibilities, including differences in healthcare utilization, healthcare system factors, clinician decision-making, and biological differences in how cancers develop and progress. They ultimately state that we need a better understanding of how these mechanisms drive differences before placing all our eggs in one basket, which is appreciated.

Too often, we see a pattern and immediately search for a single explanation. But health is rarely that simple. In fact, one of the most valuable contributions of this study may be that it reminds us to be a little more cautious and a lot more curious.

Maybe We’re Asking the Wrong Question

When we hear that men are diagnosed with cancer later, the first question is usually: Why don’t men seek care sooner? It’s a reasonable question. But perhaps it isn’t the most useful one.

What if we instead asked:

• Did he recognize that something was wrong?
• Did he think the symptom was serious enough to seek care?
• Once he decided to get help, could he realistically get to the services and use them in time and without a mountain of debt?

Those questions sound deceptively simple, but they point us in very different directions.

Let’s consider a common health issue for men my age (mid-50’s) that’s not so glamorous, hemorrhoids.

Mark: Notices blood when his wipes after a BM. Dismisses it because he assumes it is hemorrhoids. He had them diagnosed once before. He knows that as a construction worker, it’s a relatively common occurrence. It’s a regular joke at the work sites. Mark buys some OTC treatment and decides to wait it out for a week.

Louis: Notices blood when his wipes after a BM. He’s nervous and embarrassed to ask a friend. He feels confused about the information online and doesn’t trust what he’s reading. Louis can’t decide what OTC treatment to purchase. He thinks that a little blood can’t be bad enough to go to the doctor’s office.

Zach: Notices blood when his wipes after a BM. He wants to go to see a doctor, but he doesn’t have health insurance. Zach’s job is hourly at a national box-store and he’s living paycheck to paycheck. The potential cost is the first thing that comes to mind whenever he gets sick. A trip to the urgent care would set him back at least $200, which is not in his budget. He asks some friends about what to do and tries the OTC options that were suggested.

These three men all have the same symptom, but they have three different problems. If we assume they all need the same solution, we’re probably wrong.

Too often, we see a pattern and immediately search for a single explanation. But health is rarely that simple. One of the most valuable contributions of this study is the reminder to be a little more cautious and a lot more curious.

Same Symptom. Different Problems.

What strikes me about these three men is not that they all delayed seeking care, but why they delayed.

Mark doesn’t believe he has a serious problem.

Louis isn’t convinced his symptoms warrant medical attention.

Zach’s decision is based on an outside factor, money. Zach knows he should be seen, but the financial consequences of seeking care feel more immediate than the possibility that something serious is wrong.

From a distance, all three men appear to have made the same choice. Look a little closer, though, and you see three very different problems. Those differences matter because they point toward different solutions. If we describe all three men as simply “avoiding healthcare,” we flatten their unique experiences into a stereotype. And if we misunderstand the problem, we shouldn’t be surprised when our interventions have only limited success.

I know my example is ridiculous, but humor me. Imagine all three men seeing the same campaign encouraging them to see a doctor: “If your toilet paper is telling a story, don’t skip the ending. See your doctor!” Mark may still self-diagnose and treat. Louis may still question whether his symptoms are serious enough to seek care. And Zach may agree with the message and still stay home because the financial barriers haven’t changed.

The campaign isn’t wrong. It just isn’t enough. Before we decide how to help men seek care earlier, we first need to understand why different men are arriving later in the first place.

Health Doesn’t Happen in a Vacuum

The stories above illustrate something that men’s health researchers have increasingly recognized: health decisions don’t happen in isolation. If motivation were the single driving factor for seeking care, public health would be easy. It’s not.

Research has found that showing up at the doctor (for men and women) is driven by factors such as:

• Having a primary care provider,
• Whether we trust the healthcare system,
• Whether we can afford to miss work,
• Whether a loved one encourages an appointment,
• Whether appointments are available when we need them,
• Whether referral pathways create a new layer of complexity, and
• Whether we’ve had positive or negative experiences with healthcare in the past.

My work often focuses on the role of gender norms in these decisions. Yes, they are important, but they are not the entire story either. None of these issues alone explains why men with cancer present at a later stage and have worse outcomes. But they remind us to look at both the social and structural systems we travel to receive care.

Curiosity Before Certainty

This reminds me of the Ted Lasso scene where Ted mistakenly attributes a quote to Walt Whitman during a high-stakes game of darts: “Be curious, not judgmental.”

That’s a lesson I keep coming back to in men’s health. Simple explanations are appealing because they’re simple. If we decide men are diagnosed later because they don’t care enough, then the solution seems obvious: “tell men to care more.” But if a late diagnosis reflects a combination of factors as described above, then the solutions become more thoughtful and more effective.

That’s why this study resonated with me: it reminds us how easily we mistake an observation for an explanation. Men are diagnosed at later stage of cancer diagnosis and this results in higher cancer-related mortality. This study confirmed that with a robust dataset.

What we are left with is the question, “Why are men diagnosed with cancer later?” This is a much more complicated question than one study can define. It doesn’t tell us to stop thinking about masculinity, health behaviors, or help-seeking. It simply reminds us that each of those and other factors may be only part of a much larger story.

I can imagine putting “If your toilet paper is telling a story, don’t skip the ending. See your doctor!“ on a billboard. Yet, I wouldn’t expect it to work for Mark, Louis, and Zach in the same way, if at all.

 

Reference:

Maclin, B. J., Shiels, M. S., Bhattacharjee, P., & Jackson, S. S. (2026). Sex Differences in Cancer Stage at Diagnosis of Nonreproductive Solid Organ Tumors in the United States, 2015 to 2022. Cancer Epidemiology, Biomarkers & Prevention, 35(7), 1166-1173.