Dr Neil Polwart, NovarumTM DX founder and BBI Group Head of Mobile, has over a decade of experience in the delivery of next generation diagnostic mobile health technolgy (mHealth).
With recent studies [1] showing a sharp spike in the number of men under 50 developing bowel cancer, attention is turning to how new mobile health technology could help men take control of their health – particularly when it comes to taboo conditions that they may rather sweep under the rug.
The fourth most common cancer in the UK, it’s estimated that cases of bowel cancer in Europe are rising by more than seven per cent a year among those in their 20s and 30s. But although men are more likely to be diagnosed with bowel cancer than women, they’re also more likely to ignore invitations for screening – with the NHS showing [2] that just 53 per cent of men complete their bowel cancer screening test compared with 58 per cent for women.
We are stereotypically bad at seeking professional medical advice, especially when dealing with delicate parts of our anatomy. This might seem ironic given our legendary reputation for exaggerating symptoms and turning a common cold into “man flu”, but when it comes to life and death, we have a tendency to bury our heads in the sand.
Things are no better with the other taboo of male health: fertility, an issue that some might say gets right to the heart of masculinity.
With average sperm counts plummeting across the western world, men are facing a fertility crisis. A landmark study by the Hebrew University of Jerusalem [3], published in 2017 showed that among men from Europe, North America and Australia, sperm counts have declined by almost 60% in less than 40 years.
However, although male factors are responsible in 50 per cent of infertility cases, men’s needs are largely unmet and they are often an after-thought in the fertility journey. When men are brought into the equation – they often face an uncomfortable and awkward experience during diagnosis.
Conversely, with 1:500 vasectomies spontaneously reversing; men who aren’t trying to become fathers may be just as keen as to know if everything is as expected.
With this in mind, it might seem odd then that while there is an increasing number of mobile applications targeting women’s health, and female fertility in particular there are very few looking to address the issues men face. All the more peculiar, given the perception of men being particularly likely to engage with mobile health technology.
Is there potential there to let men use the phone that’s in their pocket already bursting with apps to help diagnose, monitor or track disease? In many cases, simple point of care diagnostic tests exist to track the issues of greatest concern but such tests can be somewhat intimidating to the lay user.
This is where we see an opportunity, whether it be for fertility testing, cholesterol tracking or bowel screening: guiding the user visually through step-by-step instructions on their own phone to perform a test and then using the camera to capture and interpret the result, before immediately sharing that result with experts who can guide the user to the most appropriate follow-up.
Generally speaking, earlier intervention not only brings benefits to patients, but also offers cost savings to healthcare providers. Even with large-scale screening programmes where millions of tests are performed annually we can see the opportunity for wholesale disruption of classical models: why ask patients to mail a stool sample (with all the necessary biohazard precautions that go with that) when you could have them test at home and have the results securely transferred over the web?
This could provide reassurance to the 99 per cent of users who will test negative more quickly and help encourage uptake of screening. Creative use of social media could even see successful users of such an app promoting it to their peers.
Perhaps in the future we will see mobile health technology businesses building up social communities “competing” to get their cholesterol down the way that Fitbit™ and others allow users to compare activity levels. Positioned correctly, this competitive spirit might particularly work with the male psyche.
All the signs are that it is a matter of how and when, not if, point of care testing on the phone in your pocket becomes as routine as using a phone to pay for your coffee or hold your boarding pass before you get on a flight. Will men be the group that embrace this on a large scale first?
References
1 https://gut.bmj.com/content/early/2019/06/11/gutjnl-2018-317592