Globally, men die younger than women by an average of five years. The reasons are manifold: risk-prone behaviours, biological vulnerabilities and socio-economic factors all play their part. Yet, the neglect of men’s health in policy frameworks exacerbates the toll. Prostate cancer, the second most common cancer worldwide and the leading cancer in men across 112 countries, illustrates this neglect starkly.

While advances in treatment have been made over recent decades, many men—especially those in low-income countries and high-risk groups—face late diagnoses and poor outcomes. This is not merely a medical failure but a systemic one. Early detection, effective treatment and awareness remain inconsistent or absent, particularly where they are needed most.

The World Health Organisation (WHO) has yet to establish a dedicated global framework for prostate cancer, leaving national governments to wrestle with incomplete cancer plans that often omit this significant disease. The result is predictable: rising incidence, soaring mortality rates and families devastated by a preventable crisis.

Biology Meets Environment

Prostate cancer is a complex beast. It arises in the prostate gland—a walnut-sized organ behind the bladder—largely affecting men over 50. The disease’s biology involves genetic mutations leading to uncontrolled cell growth. Certain inherited gene variants predispose men to higher risk; for example, BRCA mutations (better known for breast cancer) also elevate prostate cancer risk.

Environmental factors cannot be discounted. Diets rich in red meat and dairy, obesity, sedentary lifestyles and exposure to certain chemicals may influence risk, though evidence remains inconclusive. Socio-economic status intertwines with these factors: poorer men often face greater exposure to risks and less access to healthcare.

A crucial challenge is that early-stage prostate cancer tends to be asymptomatic. Without screening, many cases remain undetected until advanced stages, when treatment is less effective and more costly. This silent progression underlines the importance of organised screening programmes—a public health intervention still rare globally.

From Discovery to Modern Challenges

The prostate gland’s role in male reproductive health was known since antiquity, but understanding its diseases only took shape in the 19th and 20th centuries. The development of the prostate-specific antigen (PSA) test in the late 1980s revolutionised detection; suddenly, clinicians could screen asymptomatic men for prostate abnormalities.

Yet PSA testing sparked debate. Its low specificity led to overdiagnosis and overtreatment, sparking fears of unnecessary surgeries and side effects like impotence or incontinence. This controversy slowed widespread adoption of screening programmes, especially in resource-limited settings.

Meanwhile, treatment options evolved: from radical prostatectomy to radiation therapy and hormone treatments. More recently, targeted therapies and immunotherapies have offered hope for advanced cases. However, disparities in access mean many men worldwide cannot benefit from these advances.

Men’s Health on the Back Burner

Despite men representing the majority of senior health decision makers in many countries, their unique health needs are often overlooked. Global reviews show that fewer than one in five sexual and reproductive health policies address men specifically; primary healthcare policies are even less attentive.

The barriers men face in accessing care are manifold: inconvenient GP hours, cumbersome appointment systems, lack of tailored information and cultural stigma around male health concerns. These factors discourage early health-seeking behaviour.

Prostate cancer exemplifies how policy silence translates into real-world harm:

• Many countries lack dedicated prostate cancer policies or inclusion in national cancer plans.
• Public awareness campaigns are scarce or fail to reach those at highest risk.
• Screening remains patchy
• Treatment access is uneven
• Psychosocial support for patients is minimal.

This neglect is costly—not only in human terms but also economically. Late-stage cancers demand intensive treatment and impose burdens on healthcare systems and families alike.

The Case for a Global Initiative

Various global initiatives have called for a WHO-led Global Prostate Cancer Initiative to address these gaps comprehensively—from prevention through palliative care.

Key elements include:

• National governments developing explicit prostate cancer policies.
• Public education campaigns targeting stigma and misinformation.
• Organised screening programmes designed with local contexts in mind.
• Prioritising high-risk populations: Those with family history, lower socio-economic groups.
• Ensuring affordable access to treatments and psychosocial care.
• Investing in research and healthcare infrastructure, particularly in low-income demographics.

The potential gains are substantial: studies suggest organised screening could reduce prostate cancer mortality by 20-30 per cent. Targeted interventions would also help narrow glaring racial and socio-economic disparities.

Men’s Health Requires Broader Reform

Addressing prostate cancer alone will not solve the broader crisis of men’s health. Men’s underutilisation of primary care services remains a global challenge—with consequences extending to hypertension, diabetes, cholesterol management and other cancers.

Innovative delivery models—taking healthcare to workplaces, gyms or places of worship—can improve engagement. Tailored health literacy campaigns that speak directly to men’s concerns and communication styles are needed.

Crucially, public health must tackle entrenched risk behaviours—smoking, excessive alcohol consumption, poor diet—with messaging crafted for male audiences rather than generic or patronising tones.

Commercial advertisers have long mastered how to appeal to men’s identities; healthcare providers could learn from their playbook rather than relying on bland exhortations.

Prostate cancer stands at a crossroads—a disease whose trajectory can still be altered through concerted global effort. Its rise exposes systemic blind spots in men’s health that ripple far beyond oncology. Yet progress depends on recognising men not as peripheral patients but as central stakeholders whose health outcomes reflect broader societal priorities.

The data are clear; the tools exist; what remains is political will and strategic action. As policymakers and health systems confront this challenge, the question lingers: will men’s health finally move from shadow to spotlight?