Patterns and Presentation of Prostate Cancer in the Brong Ahafo Region of Ghana: A 6-Year Single Center Retrospective Study

Egote, Alexander K.; Ossei, Paul Poku Sampene; Agyeman-Duah, E; Taylor, John R.; Quarshie, E.

doi:10.4236/health.2019.114031

Cited by 6 publications

(3 citation statements)

References 20 publications

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“…Therefore, it is not surprising that prostate cancer occurred in 36.4% of all prostate diseases reported at the site of the analysis. Although this rate is lower than the 40.07% recorded in our previous studies [9] and the 39.0% prevalence recorded in Kumasi by Gyamfi et al, [10] in 2014. Similar findings have been reported in Senegal and South Africa with a prevalence rate of 30.6% and 43% respectively [2].…”

Section: Discussioncontrasting

confidence: 70%

Untitled

2019

JNH

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Introduction: Prostate cancer is gradually reaching a very high incidence in Africa, especially in the Sub-Saharan region. Understanding the dynamics in occurrence of the disorder is one approach to developing effective public health programmes and interventions that will help curb the rising incidence. Objective: This study was aimed at providing comprehensive and credible data on prostate cancer by assessing the incidence, trend and presentation in the Brong Ahafo Region of Ghana. We sought to provide region-specific hardcore data that will help to assess the issue and provide remedies. Methodology: All prostate disease cases recorded from the year 2009 to 2018 were retrospectively reviewed. Subjects from 40 years and above were eligible for screening. Diagnostic and screening tools for prostate cancer at the study site include family history, serum prostate specific antigen (PSA) test, digital rectal examination, urological ultrasound scan and histopathology (biopsy). Age, PSA values and year of screening/diagnosis were also retrieved from patient folders for the study. Histological findings and parameters considered in the study included diagnosis, carcinoma grading, perineural invasion (PNI) and percentage of affected tissues (%TA). Results: Prostate cancer cases were 369, representing 36.4% of the 1,014 prostate diseases studied. The highest annual incidence was recorded in 2014 with 51 cases (13.8%). The ages of patients ranged from 46 to 101 years with a modal age range of 70-79 years and a mean ± SD of 72.2 ± 9.8. The mean PSA value recorded was 37.1ng/ml (±107.3) with predominance in the 11-20.9 ng/ml range. Majority of Group Grade 2-5 (79%) constituted progressive prostate cancer. There was no significant correlation (p = 0.091) between grade of prostate cancer and perineural invasion. Conclusion: There is a high incidence of prostate cancer in the Brong Ahafo Region of Ghana (32 per 100,000), predominantly advanced prostatic carcinoma. Reported cases also show high %TA (38.7%) and PNI (38.0%). Early screening for prostate diseases should be encouraged to avoid progression to advanced stage and public health interventions are needed to address some of these issues.

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Section: Discussioncontrasting

confidence: 70%

Untitled

2019

JNH

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“…This situation leaves the newly diagnosed PCa patient confused as he does not know the financial cost required of him or his caretakers. The evidence from Ghanaian epidemiologic studies indicates that PCa is usually diagnosed at advanced stages [ 5 , 8 ]. An awareness or knowledge of the cost of diagnosing and managing the disease could influence men to screen and if possible, advocate for early detection.…”

Section: Introductionmentioning

confidence: 99%

The direct cost incurred by patients and caregivers in diagnosing and managing prostate cancer in Ghana

Wiafe

Mensah

Appiah

et al. 2022

BMC Health Serv Res

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Background Over the years, the prevalence of prostate cancer (PCa) has been on the increase. Poor prognosis has been a reflection of increased advance-staged diagnosis and inadequate financial assistance. The prioritization of resources cannot be effective enough to factor in the unexpected economic burden resulting from ill health unless health economic approaches are utilized to estimate the cost of diseases including PCa. With the absence of data on the cost of PCa in Ghana, and the evidence of the benefits of PCa cost-of-illness studies on cancer financing, it has become imperative to investigate the direct health cost of PCa on patients and careers. Hence, we investigate the cost of PCa diagnosis and management, the availability and prices of PCa medications, and the affordability of PCa care in Ghana. Methods The prevalence approach to cost-of-illness studies was adopted in this study through a random selection of two (2) hospitals, four (4) private laboratories, and ten (10) private community pharmacies in the Ashanti Region of Ghana. The diagnostic and management cost of PCa was investigated through the application of validated data collection instruments to representatives of the selected hospitals and laboratories. The availability and prices of PCa medications were studied with the administration of a validated tool to representatives of the selected pharmacies. The data were analyzed with Microsoft Excel Spreadsheet and the affordability of care was assessed considering the 2021 Ghana National Daily Minimum Wage (GNDMW). Results The cost of diagnosing non-metastatic and metastatic PCa were respectively estimated at GHC 1686.00 ($ 290.58) and GHC 6876.00 ($ 1185.09). Radical prostatectomy, as a management option, was estimated at GHC 2150.00 ($ 370.56) higher than Extended Beam Radiotherapy (GHC 2150.00: $ 370.56). The mean PCa drug availability for the sampled pharmacies around the public hospital, all the sampled pharmacies, and around the private hospital were respectively 61.54, 51.54, and 41.54%. None of the sampled drugs at the stated strengths had a 100% availability. A 6-month androgen deprivation therapy employing goserelin was GHC 3000.00 ($ 517.05). The median drug price ratio (MDPR) was 0.72 - 15.38, with generic bicalutamide 150 mg tablets as the cheapest and generic flutamide 250 mg tablets as the most expensive. Conclusion The diagnostic and management cost of PCa currently overwhelms the average Ghanaian because the minimum daily wage in 2021 is GHC 12.53 ($ 0.46). A higher economic burden was associated with metastatic PCa and hence, the need for strategies to improve early detection. Also, the inclusion of PCa management in the National Health Insurance Scheme would lessen the financial burden of the disease on patients and careers, and improve management outcomes.

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“…The modal age range of incidence of CaP in Ghana is estimated to be from 70 to 79 years with the lowest occurrence recorded among men who are either between 40 and 49 years or more than 100 years old [ 18 ]. In this study, however, most of the patients with localised CaP were between 60 and 69 years old.…”

Section: Discussionmentioning

confidence: 99%

Biochemical outcome after curative treatment for localized prostate cancer with external beam radiotherapy: a cross-sectional study

Daniels,

Adesi Kyei,

Badejoko–Okunade

et al. 2023

ecancer Journal

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Although many patients who receive definitive radiotherapy (RT) for localised prostate cancer (CaP) experience long-term disease-free survival and better quality of life, some also have biochemical progression during follow-up. Oftentimes this implies additional treatment for patients with the accompanying challenges of cumulative treatment side effects, inconvenience and financial toxicity. This study retrospectively assessed the clinicopathological characteristics and biochemical outcomes of patients treated for localised CaP with external beam radiotherapy (EBRT) between 2015 and 2020 at a major cancer treatment centre in Accra, Ghana. Patients’ socio-demographic and clinical data were collected from their hospital records and analysed with the Statistical Package for Social Sciences version 26. Biochemical failure (BCF) was defined as an increase in the level of serum prostate-specific antigen (PSA) >2 ng/mL above the nadir after curative therapy based on the Phoenix definition. The mean age was 67.6 years (SD ± 6.2). The majority of the study participants ( n = 79, 64.8%) had initial PSA >20 ng/mL, with the highest recorded value of 705 ng/mL. All the patients had biopsy-proven adenocarcinoma of the prostate gland. Some patients received 3-dimensional conformal radiotherapy (3DCRT) on a cobalt-60 teletherapy machine whereas others were treated with either 3DCRT or intensity-modulated radiotherapy (IMRT) on a 6 MV Linac. In all, 13.1% of the patients experienced BCF after receiving EBRT after an average follow-up of 31.3 months. This study demonstrated a low rate of BCF among patients treated with EBRT for localised CaP in Ghana. Strong prognostic factors of biochemical outcome demonstrated in this study were the percentage of cores positive, grade group, and risk stratification. Diarrhaea and desquamation experienced by treated CaP patients were exclusively attributable to EBRT. RT produced a complete resolution of symptoms in some of the patients.

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Patterns and Presentation of Prostate Cancer in the Brong Ahafo Region of Ghana: A 6-Year Single Center Retrospective Study

Cited by 6 publications

References 20 publications

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The direct cost incurred by patients and caregivers in diagnosing and managing prostate cancer in Ghana

Biochemical outcome after curative treatment for localized prostate cancer with external beam radiotherapy: a cross-sectional study

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