title: Psychosocial factors that influence men's help-seeking for cancer symptoms: a systematic synthesis of mixed methods research.
abstract: OBJECTIVE
  Effectiveness of cancer control partly depends upon early identification and treatment. Men appear to be more likely to delay help-seeking for symptoms, resulting in later diagnosis. This review aims to provide a mixed research synthesis of the psychosocial barriers to and facilitators of help-seeking for cancer symptoms among men.
  
  
  METHODS
  Systematic methods were followed, including a predefined research question and search strategy. Searches retrieved 7131 international records from online databases: MEDLINE (n = 3011), PubMed (n = 471), SCOPUS (n = 896), Informit (n = 131), PsychINFO (n = 347), and Web of Science (n = 2275). Forty studies were eligible for inclusion in the review (25 qualitative studies, 11 quantitative studies, and 4 mixed-method studies).
  
  
  RESULTS
  There was strong observational evidence for several psychosocial barriers to men's help-seeking behaviour: low cancer knowledge and inaccurate symptom interpretation, embarrassment and fear, and conformity to masculine gender role norms. The strongest facilitating factor associated with men's help-seeking behaviour was encouragement and support of spouses and family members. The majority of research was qualitative and used small samples, making generalisations to the wider population difficult.
  
  
  CONCLUSIONS
  Men's help-seeking for cancer symptoms is influenced by several psychosocial factors, which, in part, may be gender-specific. Health promotion initiatives to improve help-seeking behaviour among men should aim to increase cancer knowledge, reduce embarrassment and fear, address social norms deterring timely help-seeking, and acknowledge informal help-seeking with spouses and family members. Increasing the theoretical grounding of research could aid cohesion across the research area and the design of effective health promotion interventions. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Bedford Park, South Australia, Australia.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Fish
authors.affiliation: Social Health Sciences, School of Health Sciences, Flinders University, Bedford Park, South Australia, Australia.
authors.forename: Ivanka
authors.initials: I
authors.lastname: Prichard
authors.affiliation: Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
authors.forename: Kerry
authors.initials: K
authors.lastname: Ettridge
authors.affiliation: Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Grunfeld
authors.affiliation: Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Bedford Park, South Australia, Australia.|Cancer Council SA, Eastwood, South Australia, Australia.
authors.forename: Carlene
authors.initials: C
authors.lastname: Wilson
keywords: cancer; gender; help-seeking; oncology; systematic review