SIU 2018: Men’s Health: A Global Perspective

Seoul, South-Korea (UroToday.com) Men’s health is a discipline that promotes physical, mental, and social well-being of men throughout their life cycle (from boyhood to manhood) and addressing health problems related to them. In most parts of the world, health outcomes among boys and men continue to be substantially worse than among girls and women. This gender-based disparity in health has received little national, regional, or global acknowledgment or attention from health policy-makers or health-care providers. Unfortunately, to date, there is not much data that reports men’s health exclusively.

When looking at the population pyramids in Asia and Europe, clear differences are seen in the percentage of the elderly population, which is substantially higher in Europe, demonstrating a much higher life expectancy in Europe than in Asia. When looking at the male population around the world, the highest male population is in China, India, and Indonesia. The countries with the highest male to female ratio are Qatar (3:1), UAE (2:1) and Kuwait (1.45:1). All around the world, the life expectancy of women has always been higher than that of men. In the European Union, the life expectancy of men is 76.1, while in women it was 82.2. Life expectancy has a linear relationship with the income of its civilians. 

Dr. Lukham moved on to discuss the prevalence of cardiovascular disease (CVD) among men around the world. The prevalence of risk factors for CVD are considerably lower in Asia, except for smoking. Within Asia, men in higher income countries tend to drink more, smoke less, have higher levels of hypercholesterolemia, are less physically active and more overweight compared to men in poorer income countries. Asian men to tend to smoke more and be physically more active than men in Europe but consume less alcohol.

When assessing disease burden, males, in general, have a much higher burden than women, even in genitourinary disease, and this applies to both Europe and Asia. The burden of cancer was next addressed, showing again a higher burden of cancer among men all around the world, including in genitourinary cancers. When assessing bladder cancer specifically, the mortality to incidence ratio is the highest in Africa, then Asia, Europe, and Oceania. Similar data have been shown for prostate and testicular cancer, while penile cancer is more common the western countries.

There is also interesting data demonstrating that the sperm count has declined significantly among men in western countries, but no significant declines have been shown in South America, Asia, and Africa. Moreover, erectile dysfunction rates are on the rise, especially in western countries.

Dr. Lukham summarized his talk stating all the main factors that affect men’s health and life expectancy, which are divided into four main categories:

  1. Lifestyle-related factors – smoking, alcohol and other cardiovascular risk factors
  2. Socio-cultural factors – poor socio-economic status, unattended stress, high-risk occupation, unemployment, poor social support, men-health seeing behavior
  3. Biological factors – better protection from oxidative stress in women, the compensatory effect of the second x chromosome, telomere length, more active female immune function, protective effect of estrogen in women
  4. Male-specific factors – erectile dysfunction, premature ejaculation, testosterone deficiency syndrome, prostate, testicular and penile cancer
To increase men’s health status, it is imperative that the health insurance coverage is increased among young men, that there is effective disease management program, particularly for middle-aged men, and that more studies on men’s health are performed. Dr. Lukham concluded his encompassing talk stating that in a public health approach, healthcare stakeholders should recognize the importance of men’s health and it should receive as much attention as is paid to maternal and child health, without diminishing efforts for women and children.

Presented by: Hakim Lukman, Indonesia

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre at the 38th Congress of the Society of International Urology - October 4- 7, 2018 - Seoul, South Korea
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