The demand between men and women for medical care in the Unified Health System (SUS) remains unbalanced, although the gap between genders has been reducing over the years.
An unprecedented survey by the Brazilian Society of Urology (SBU), with data from the Ministry of Health’s Outpatient Information System, indicates that, while more than 312 million men have already been treated in 2022, women exceed 370 million. Last year there were more than 725 million men against more than 860 million women.
For the coordinator of the Department of Andrology, Reproduction and Sexuality of the SBU, Eduardo Miranda, for cultural reasons, men go to the doctor less than women.
“There is still a certain taboo, often [eles] they do not have a culture of self-care and going to the doctor is seen as a sign of weakness. There is also the cultural issue. The girl is taken by the mother to the gynecologist from the first period, while the man does not go to the doctor after he no longer needs regular follow-up with a pediatrician. This is a process that we need to work on over generations and I hope we can see an increase in men going [aos consultórios] for routine follow-up with the urologist,” he said.
The difference in demand between men and women is very evident in the specific services. This year, there were more than 1.2 million female visits by gynecologists, but men’s demand for urologists was 200,000 visits.
“Women are more used to having annual preventive exams and are more concerned about their health. They usually make appointments for their husbands. But men have been looking more to the urologist for greater awareness through campaigns, for example”, highlighted the supervisor of the SBU bladder cancer discipline, Felipe Lott.
For the president of the SBU, Alfredo Canalini, the main causes that keep men away from medical appointments are fear and misinformation. “But the campaigns that the SBU promotes year after year indicate a change in behavior, and we already feel a significant difference with spontaneous search, especially for prostate evaluation”, he argued.
The Communications Director of the SBU, Karin Anzolch, pondered, however, that, despite men being more aware of health care, studies of this type show that there is still a long way to go. The doctor added that, by acting in extremely impacting problems on the quality of life and survival of men, Urology supports the cause.
Alert
Based on the data and taking advantage of Men’s Day, celebrated today (15), the SBU warns of the importance of caring for men’s health, especially for the prevention of bladder cancer, which, according to the entity, is the second most common urological tumor in this population. First is prostate cancer.
“This month, the SBU also warns about bladder cancer, which affects three times more men than women, and is the second most frequent tumor in urology, only behind prostate cancer, knowing that many are still unaware of the factors involved. risk factors and warning signs for this disease, which can be very serious and devastating”, Karin reported.
The SBU also reported that estimates from the National Cancer Institute (Inca) indicate that, in 2022, 7,590 new cases will be identified among men and 3,050 among women. Inca figures also indicate that, in 2020, there were 4,595 deaths caused by bladder tumors. Among them, 3,097 in men and 1,498 in women.
According to the coordinator of the Department of Uro-Oncology at SBU, Ubirajara Ferreira, in 80% of cases the initial symptom is blood in the urine, which, when noticed, should be followed by an imaging test, preferably tomography of the abdomen. “The prognosis depends on the extent of invasion of the bladder wall. If it affects only the inner surface of the bladder, it has a 90% survival rate at five years. If it invades the entire wall, it can drop to 40% in five years,” he explained.
The main risk factor for the disease is smoking, related to 50% to 70% of cases. “Other factors can also influence, such as exposure to chemical compounds such as aromatic amines, aristolochic acid (dietary supplements), pioglitazone (diabetes medication), arsenic in drinking water, low fluid consumption, chronic irritations, infections, genetic factors, chemotherapy , radiotherapy”, stated Felipe Lott.
With advancing age, prostate diseases and sexual dysfunction are among the main diseases that affect men. In adolescence and adulthood are sexually transmitted infections. According to Eduardo Miranda, there are other diseases that are more prevalent, such as hypertension, heart disease, diabetes and obesity. The reason that takes a man to the doctor depends on his age group.
“In childhood, they are usually alterations of the genitourinary tract, phimosis, hernia. In adolescence, most do not attend the clinic, and this is something that the SBU has been trying to change. In young adults, it is usually fertility difficulties, kidney stones. From the age of 40 onwards, we routinely go to the prevention of prostate cancer and the benign growth of the prostate and urinary symptoms already begin to appear. From the age of 50 onwards, complaints of erectile dysfunction are common and urinary symptoms progressively increase”, observed Eduardo Miranda.
other diseases
In other diseases that affect men, 5% of all cancer cases correspond to testicular cancer. For prostate cancer, the estimate is more than 65,000 new cases. In 2021, there were 1,791 cases of penile cancer.
Benign prostatic hyperplasia affects about 50% of individuals over 50 years of age and, after the age of 40, erectile dysfunction is prevalent in Brazil in about 50%, something around 16 million men.
Campaigns
In addition to the Men’s Day campaign, SBU develops the Blue November and also the #VemProUro, which, in September, will be in its fifth edition. “[Elas] intend to encourage men to know more about health and maintain a regular routine of care, understanding that habits are created from an early age, and preventive monitoring helps to introject these values, provide learning and guide to attitudes that will make a difference later on. Therefore, urology is a partner of men’s health throughout its life cycle”, concluded Karin Anzolch.
