Barriers to Prostate Cancer Screening by Men in Sub‐Saharan Africa: An Integrated Review

Baratedi, William Mooketsi; Tshiamo, Wananani; Mogobe, Keitshokile Dintle; McFarland, Ditsapelo M.

doi:10.1111/jnu.12529

Cited by 37 publications

(38 citation statements)

References 33 publications

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“…In the study, lack of knowledge on PC was reported as a major barrier to uptake of screening. This finding is corroborated with studies conducted among men in the Sub-Saharan African region and Kenya (8,9,15). Participation of men in screening is highly dependent on their knowledge about PC and the benefits of early detection.…”

Section: Discussionsupporting

confidence: 81%

Barriers and Facilitators to Uptake of Prostate Cancer Screening in a Kenyan Rural Community

Mbugua¹,

Karanja²,

Oluchina³

2021

Ann Afr Surg.

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Background: Prostate cancer (PC) is curable with early detection, yet it remains a major public health problem globally and a leading cause of mortality among men. The objective of the study was to explore the barriers and facilitators to the uptake of prostate cancer screening among men aged 40–69 years in a rural community in Kenya. Methods: We utilized an explorative qualitative design and purposive sampling to select participants. Six focus group discussions (FGDs) and seven in-depth interviews were conducted among 59 men aged 40–69 years and key informants in Kiambu County, Kenya. Data was collected using a semi-structured guide and content analysis was done. Results: The facilitators of screening included experience of symptoms, proximity and prominence of cancer, accessibility, and advocacy. The barriers to screening included lack of knowledge, fatalistic beliefs, low risk perception, stigma, and male dominance factors. Conclusion: This study provides vital information for the development of interventions to enhance shared decision-making in regard to PC screening. Capacity building of clinicians, task shifting and provision of well-coordinated affordable culturally sensitive screening services should be explored. The concerted effort among policy makers and all health care workers to overcome the stated barriers to screening is highly recommended.

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Section: Discussionsupporting

confidence: 81%

Barriers and Facilitators to Uptake of Prostate Cancer Screening in a Kenyan Rural Community

Mbugua¹,

Karanja²,

Oluchina³

2021

Ann Afr Surg.

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“…1,3 Studies on the uptake of screening show a lack of early-detection services and public awareness. 4,5 Accordingly, hospitalbased studies reveal that most patients present with symptomatic disease and are diagnosed at late stages. 6 African American and Afro-Caribbean race has been associated with a more aggressive form of PCa and poorer outcomes in comparison with other population groups.…”

Section: Introductionmentioning

confidence: 99%

Presentation, patterns of care, and outcomes of patients with prostate cancer in sub‐Saharan Africa: A population‐based registry study

Seraphin

Joko‐Fru

Hämmerl

et al. 2021

Cancer

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BACKGROUND: Although prostate cancer (PCa) is the most commonly diagnosed cancer in men of sub-Saharan Africa (SSA), little is known about its management and survival. The objective of the current study was to describe the presentation, patterns of diagnosis, treatment, and survival of patients with PCa in 10 countries of SSA. METHODS: In this observational registry study with data collection from 2010 to 2018, the authors drew a random sample of 738 patients with PCa who were registered in 11 population-based cancer registries. They described proportions of patients receiving recommended care and presented survival estimates. Multivariable Cox regression was used to calculate hazard ratios comparing the survival of patients with and without cancer-directed therapies (CDTs). RESULTS:The study included 693 patients, and tumor characteristics and treatment information were available for 365 patients, 37.3% of whom had metastatic disease. Only 11.2% had a complete diagnostic workup for risk stratification. Among the nonmetastatic patients, 17.5% received curative-intent therapy, and 27.5% received no CDT. Among the metastatic patients, 59.6% received androgen deprivation therapy. The 3-and 5-year age-standardized relative survival for 491 patients with survival time information was 58.8% (95% confidence interval [CI], 48.5%-67.7%) and 56.9% (95% CI, 39.8%-70.9%), respectively. In a multivariable analysis, survival was considerably poorer among patients without CDT versus those with therapy. CONCLUSIONS: This study shows that a large proportion of patients with PCa in SSA are not staged or are insufficiently staged and undertreated, and this results in unfavorable survival. These findings reemphasize the need for improving diagnostic workup and access to care in SSA in order to mitigate the heavy burden of the disease in the region.

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“…A recent review from Baratedi et al, similarly pointed towards lack of knowledge and a multitude of misconceptions about the disease. This study also identified lower education and socioeconomic status as barriers to prostate cancer screening on the patient level [ 43 ]. These factors are also known to influence the outcome of prostate cancer patients in general [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Prostate cancer survival in sub-Saharan Africa by age, stage at diagnosis, and human development index: a population-based registry study

Seraphin

Joko‐Fru

Manraj

et al. 2021

Cancer Causes Control

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Objectives To estimate observed and relative survival of prostate cancer patients in sub-Saharan Africa (SSA) and to examine the influence of age, stage at diagnosis and the Human Development Index (HDI). Patients and methods In this comparative registry study, we selected a random sample of 1752 incident cases of malign prostatic neoplasm from 12 population-based cancer registries from 10 SSA countries, registered between 2005 and 2015. We analyzed the data using Kaplan-Meier and Ederer II methods to obtain outcome estimates and flexible Poisson regression modeling to calculate the excess hazards of death Results For the 1406 patients included in the survival analyses, 763 deaths occurred during 3614 person-years of observation. Of patients with known stage, 45.2% had stage IV disease, 31.2% stage III and only 23.6% stage I and II. The 1 and 5-year relative survival for the entire cohort was 78.0% (75.4–80.7) and 60.0% (55.7–64.6), while varying between the registries. Late presentation was associated with increased excess hazards and a 0.1 increase in the HDI was associated with a 20% lower excess hazard of death, while for age at diagnosis no association was found. Conclusions We found poor survival of SSA prostatic tumor patients, as well as high proportions of late stage presentation, which are associated with inferior outcome. This calls for investment in health-care systems and action regarding projects to raise awareness among the population to achieve earlier diagnosis and improve survival.

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Barriers to Prostate Cancer Screening by Men in Sub‐Saharan Africa: An Integrated Review

Cited by 37 publications

References 33 publications

Barriers and Facilitators to Uptake of Prostate Cancer Screening in a Kenyan Rural Community

Barriers and Facilitators to Uptake of Prostate Cancer Screening in a Kenyan Rural Community

Presentation, patterns of care, and outcomes of patients with prostate cancer in sub‐Saharan Africa: A population‐based registry study

Prostate cancer survival in sub-Saharan Africa by age, stage at diagnosis, and human development index: a population-based registry study

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