The psychology of men’s help-seeking for common cancer symptoms

Author: Jennifer Fish

Fish, Jennifer, 2019 The psychology of men’s help-seeking for common cancer symptoms, Flinders University, College of Medicine and Public Health

Terms of Use: This electronic version is (or will be) made publicly available by Flinders University in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. You may use this material for uses permitted under the Copyright Act 1968. If you are the owner of any included third party copyright material and/or you believe that any material has been made available without permission of the copyright owner please contact with the details.


The early diagnosis of cancer is a proven strategy for increasing survival rates for many cancers. Despite this, men appear more likely than women to postpone help-seeking for cancer symptoms. This thesis describes a series of studies that have examined the key psychological processes underlying Australian men’s decisions to seek medical advice for cancer symptoms, with the overarching intention of identifying strategies to promote men’s timely help-seeking.

The first study was a systematic review of research investigating psychosocial influences on men’s help-seeking for cancer symptoms. Forty international studies were included in the review: 25 qualitative studies, 11 quantitative studies, and four mixed-method studies. Although a range of psychosocial factors were found to be associated with men’s help-seeking, existing research had several limitations that reduced the strength of evidence. It was concluded that future research should examine variation between men, generate hypotheses from theory, and identify the relative importance of psychosocial influences on help-seeking behaviour.

Findings from the review informed Study 2, an interview study that was conducted to explore variation in Australian men’s help-seeking for cancer symptoms between urban and rural areas. Interviews were conducted with men recently diagnosed with cancer (n = 13) and their partners (n = 8). Results indicated that help-seeking behaviour was similar for participants across regions, however, their experiences differed. Men residing in rural areas described greater difficulty with accessing healthcare and more optimism about their symptoms.

Study 3 was a cross-sectional survey that tested the predictive strength of the Theory of Planned Behaviour (Ajzen, 1991; Fishbein & Ajzen, 2010) and the Health Belief Model (Rosenstock, 1974) in order to examine their relative capacity to explain variation in Australian men’s (n = 127) intentions to seek help for cancer symptoms. Results indicated that intentions were moderately explained by the two theories in separate (each model explained 20% of variance) and combined (25% of variance explained) regression analyses, and that perceived behavioural control was the only significant predictor variable.

Considering the modest variance explained by the models in Study 3, it was important to test the predictive strength of other psychosocial variables not yet examined. This was done in Study 4, which also examined the extent to which the research-derived model was invariant between genders and countries. The fourth study was a cross-sectional survey including Australian men (n = 114) and women (n = 111), as well as British men (n = 59) and women (n = 86). Regression analyses showed that the set of predictors explained a good amount of variance in anticipated time to consultation for both male groups (34 – 40%), but less variance for female groups (14 – 22%). Perceived behavioural control and ‘Minimising problem and resignation’ were consistently strong predictors of the outcome for the Australian groups and British men.

Collectively, these studies highlighted important cognitive processes underlying Australian men’s help-seeking for cancer symptoms. Results showed the combined relevance of perceived behavioural control and symptom appraisal factors. These results have implications for the development of strategies designed to improve help-seeking for cancer symptoms.

Keywords: Help-seeking, Cancer, Oncology, Symptoms, Gender, Masculinity

Subject: Public Health thesis

Thesis type: Doctor of Philosophy
Completed: 2019
School: College of Medicine and Public Health
Supervisor: Professor Carlene Wilson