title: Masculinity and the body: how African American and White men experience cancer screening exams involving the rectum.
abstract: Past research on prostate and colorectal cancer disparities finds that barriers to screening, such as embarrassment and offensiveness, are often reported. Yet none of this literature investigates why. This study uses masculinity and health theory to examine how men experience two common screenings: digital rectal exams (DREs) and colonoscopies. In-depth interviews were conducted with 64 African American and White men from diverse backgrounds, aged 40 to 64, from North Carolina. Regardless of race or education, men experienced DREs more negatively than colonoscopies because penetration with a finger was associated with a gay sexual act. Some men disliked colonoscopies, however, because they associated any penetration as an affront to their masculinity. Because beliefs did not differ by race, future research should focus on structural issues to examine why disparities persist with prostate and colorectal cancer. Recommendations are provided for educational programs and physicians to improve men's experiences with exams that involve the rectum.
authors.affiliation: Department of Family & Community Medicine, Wake Forest University School of Medicine,Winston-Salem, North Carolina 27157-1084, USA. jwinteri@wfubmc.edu
authors.forename: Julie A
authors.initials: JA
authors.lastname: Winterich
authors.forename: Sara A
authors.initials: SA
authors.lastname: Quandt
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Grzywacz
authors.forename: Peter E
authors.initials: PE
authors.lastname: Clark
authors.forename: David P
authors.initials: DP
authors.lastname: Miller
authors.forename: Joshua
authors.initials: J
authors.lastname: Acuña
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Arcury
mesh_terms: D000328:Adult; D001741:Black or African American; D001290:Attitude; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D051517:Digital Rectal Examination; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D057228:Masculinity; D008875:Middle Aged; D008962:Models, Theoretical; D009657:North Carolina; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D044465:White People