Department of pathology, University College Hospital/ College of medicine, University of Ibadan, P,M,B, 5116, Ibadan, Oyo state, Nigeria.
Infect Agent Cancer. 2011 Sep 23;6 Suppl 2(Suppl 2):S5. doi: 10.1186/1750-9378-6-S2-S5.
Prostate cancer is the second most frequently diagnosed cancer of men (913 000 new cases, 13.8% of the total) and the fifth most common cancer overall. Prostate cancer is the sixth leading cause of death from cancer in men (6.1% of the total).The incidence of prostate cancer in Nigerian men is believed to be on the increase and it had become the number one cancer in 1999, constituting 11% of all male cancers in the population served by the Ibadan cancer Registry. Studies from Ibadan and from other sites in Nigeria (Benin, Calabar, Kano, Lagos, Maiduguri, and Zaria) have shown an increasing incidence of prostate cancer accounting for anything between 6 and 12 % of total cancers in these centres and up to about 18% of prostatic neoplasms in some. Most patients present in late stage disease, and the mortality is high.It is uncertain whether there is a biophysical component to the increased incidence of prostate cancer in Nigerian and other West African men although a few studies point in this direction.It appears there is inadequate information regarding the incidence and mortality of prostate cancer, and that health care professionals do not routinely provide information regarding the importance of screening for prostate cancer before age 50 for high-risk populations.The Revised National health Policy for Nigeria (Sept 2004) has as its long term goal 'to provide the entire population with adequate access, not only to primary health care but also to secondary and tertiary services through a well functioning referral system' and also "Ensuring equitable distribution of human resources for healthcare delivery between urban and rural areas, including difficult terrain, such as mountainous, riverine and inaccessible areas of the country."At the moment however, Public expenditure on health is less than $8 per capita, compared to the $34 recommended internationally. Private expenditures are estimated to be over 70% of total health expenditure, most of this from out-of-pocket. Yet there is endemic poverty. The National Health Insurance scheme (NHIS) is presently severely limited in its allowances and certainly so for cancer care.
The following recommendations are therefore made:* Establishment of community outreaches for education and screening.* Improved completeness of records to understand the real burden of disease and funding studies to explore biophysical components that may be important in racial differences for this disease.* Increased access by increasing numbers of specialists required for clinical assessment and management.* Increase laboratory diagnostic support* Improved availability of drugs for the treatment of prostate cancer cases.
前列腺癌是男性中第二常见的癌症（913000 例新发病例，占总数的 13.8%），也是总体上第五大常见癌症。前列腺癌是男性癌症死亡的第六大原因（占总数的 6.1%）。据信，尼日利亚男性的前列腺癌发病率正在上升，它在 1999 年成为头号癌症，占伊巴丹癌症登记处服务人群中所有男性癌症的 11%。伊巴丹和尼日利亚其他地区（贝宁、卡拉巴尔、卡诺、拉各斯、迈杜古里和扎里亚）的研究表明，前列腺癌的发病率呈上升趋势，占这些中心所有癌症的 6%至 12%，在某些地区甚至占前列腺肿瘤的 18%。大多数患者在疾病晚期出现，死亡率很高。尽管有一些研究表明，尼日利亚和其他西非男性前列腺癌发病率上升可能存在生物物理因素，但目前尚不确定这一点。关于前列腺癌的发病率和死亡率，似乎没有足够的信息，而且医疗保健专业人员通常不会提供 50 岁以下高危人群前列腺癌筛查的重要性信息。《尼日利亚修订国家卫生政策》（2004 年 9 月）的长期目标是“通过一个运作良好的转诊系统，不仅为初级卫生保健，而且为二级和三级服务，为全体人民提供充分的机会”，并“确保在城市和农村地区，包括该国山区、河流和难以到达地区等困难地形，公平分配医疗保健人力资源。”然而，目前公共卫生支出人均不足 8 美元，而国际建议为 34 美元。私人支出估计占总卫生支出的 70%以上，其中大部分来自自费。然而，这里仍然存在普遍贫困。国家健康保险计划（NHIS）目前在其津贴方面受到严重限制，癌症护理方面的限制尤其严重。
因此提出以下建议：* 开展社区外展活动，进行教育和筛查。* 提高记录的完整性，以了解疾病的真实负担，并进行研究，探索可能对这种疾病的种族差异很重要的生物物理因素。* 通过增加所需的专科医生数量来增加获得途径，以便进行临床评估和管理。* 增加实验室诊断支持* 改善前列腺癌病例治疗药物的供应。
