Helping Men Answer Important Health Questions

June is Men’s Health Month, a time to boost awareness of preventable health problems and to encourage men to seek regular medical care and early treatment for disease and injury. Men in the United States, on average, die almost five years earlier than women. They die at higher rates than women from the top causes of death, which include heart disease, cancer, injuries, and stroke. This difference may result in part from men being less likely to get routine medical exams and receive preventive services.

Here at PCORI, we’re funding a wide variety of research projects designed to help men answer important questions about their health and health care. We are comparing treatments to learn which are most effective for combating the diseases that are most deadly to men. We are also funding research that looks at how the health system can become more effective in treating men.

Heart Disease

Heart disease, the most common cause of death among both men and women, tends to strike men at a younger age. A long-standing question about preventing heart attacks and strokes is the focus of PCORI’s first trial conducted through PCORnet, the National Patient-Centered Clinical Research Network. PCORnet is a large, highly representative data network being developed to improve the nation’s capacity to efficiently conduct comparative clinical effectiveness research.

The recently approved three-year, $14 million clinical trial will compare the benefits and harms of the two commonly prescribed doses of aspirin for preventing heart attacks and strokes in people with heart disease. Most of the estimated 15.4 million Americans who have coronary heart disease take either a regular-strength (325 mg) or a low-dose (81 mg, or “baby aspirin”) aspirin daily. The PCORnet trial will randomly assign 20,000 patients who have had a heart attack or have significant blockage of their coronary arteries to use one of the two daily doses. Results of this study, to be conducted in a variety of clinical settings, will help patients and those who care for them make better-informed decisions about preventing death from heart disease.

Cancer

Cancer is the second most common cause of deaths in both men and women, with prostate cancer being one of the top killers for men. PCORI funds several studies that aim to help patients and their clinicians choose among the many available treatments for prostate cancer. Recent advances in technology have introduced new, more costly surgical and radiation treatments, which have been rapidly adopted although few studies have directly compared the results of the older and newer methods.

To address questions about treatment effectiveness, for example, a North Carolina project is comparing outcomes among 1,700 men from diverse backgrounds four to five years after diagnosis with early prostate cancer. In this observational study, the research team is relating the health care received to cancer control and quality of life. The team will use several statistical techniques to minimize the chance that differences between patients receiving different treatments will lead to misleading results.

Active & Healthy Brotherhood

One way that the health system can be more effective is to provide services tailored to patients with specific characteristics, such as weight, age, or family history of heart problems. A project we recently funded in North Carolina tests a program specially designed to help African-American men improve their health behaviors. Called Active & Healthy Brotherhood (AHB), it provides basic health information, including advice on healthy eating, physical activity, stress management, and how to get medical care.

The study participants are African-American men who have high blood pressure, diabetes, or heart disease, or are at high risk for disease because they are not eating a healthy diet or exercising. The men are randomly assigned to one of two programs. One consists of AHB group sessions over four months led by health educators and followed by phone calls to check on their progress. The other provides basic health information in videos and brochures. At the beginning of the study, after six months, and after a year, the research team will assess health behaviors and risk factors, such as blood pressure, blood sugar, and weight.

To learn about other PCORI-funded projects to advance men’s health, see our 2014 Men’s Health Month blog post, or search for a topic of interest among our funded projects. 

Luce served as PCORI’s Chief Science Officer from May 2013 – September 2015