Olorunniyi Shola Blessing, Ogo Chidiebere Ndukwe
Urology Unit, Department of Surgery, Federal Medical Centre, PMB 3031, Sapon Post Office, Abeokuta, Ogun State, Nigeria.
Ecancermedicalscience. 2025 May 29;19:1917. doi: 10.3332/ecancer.2025.1917. eCollection 2025.
Prostate cancer (CaP) is a significant global health challenge, ranking as a leading cause of cancer mortality among men, particularly in Sub-Saharan Africa. In Nigeria, CaP accounts for 37.5% of new cancer cases and a high mortality rate, largely attributed to late-stage diagnoses. While early detection through screening methods such as digital rectal examination (DRE) and prostate-specific antigen (PSA) testing can improve survival outcomes, barriers persist, especially among men of African ancestry who are at higher risk from age 40. This study explores the reasons behind delayed screening and late diagnosis in Sub-Saharan Africa, identifying barriers using the health belief model as a framework; hence, the research explored key constructs: perceived susceptibility, severity, benefits, barriers (cues to action) and self-efficacy. This cross-sectional study specifically examines these predictors among adult males attending a urology clinic in Abeokuta, Nigeria. A simple random sampling technique was used to recruit 128 study participants. The study found that, despite empirical evidence highlighting increased susceptibility to CaP from the age of 40, most participants perceived themselves as not at risk, indicating a significant lack of awareness. This low perceived susceptibility negatively impacts health-seeking behaviours, including early screening. Participants generally acknowledged the severity of CaP, which should ideally motivate preventive actions. However, many found decision-making about screening and undertaking annual DRE or PSA tests challenging, reflecting low self-efficacy. While participants recognised the benefits of preventive measures, barriers such as embarrassment, fear of pain and lack of physician recommendations were reported. Notably, the absence of screening recommendations by healthcare providers emerged as a significant gap, despite guidelines advocating early screening for men of African ancestry. These findings underscore the need for targeted interventions to raise awareness, enhance self-efficacy, address procedural concerns and encourage proactive physician involvement in recommending screenings to mitigate the high prevalence of late-stage diagnoses of CaP.
前列腺癌是一项重大的全球健康挑战，是男性癌症死亡的主要原因之一，在撒哈拉以南非洲地区尤为突出。在尼日利亚，前列腺癌占新增癌症病例的37.5%，死亡率很高，这主要归因于晚期诊断。虽然通过直肠指检（DRE）和前列腺特异性抗原（PSA）检测等筛查方法进行早期检测可以改善生存结果，但障碍依然存在，尤其是在40岁及以上风险较高的非洲裔男性中。本研究探讨了撒哈拉以南非洲地区筛查延迟和诊断较晚的原因，以健康信念模型为框架确定障碍；因此，该研究探讨了关键要素：感知易感性、严重性、益处、障碍（行动线索）和自我效能感。这项横断面研究专门调查了在尼日利亚阿贝奥库塔一家泌尿外科诊所就诊的成年男性中的这些预测因素。采用简单随机抽样技术招募了128名研究参与者。研究发现，尽管有实证证据表明40岁以后患前列腺癌的易感性增加，但大多数参与者认为自己没有风险，这表明他们明显缺乏认识。这种低感知易感性对包括早期筛查在内的寻求健康行为产生了负面影响。参与者普遍承认前列腺癌的严重性，这本应理想地促使他们采取预防行动。然而，许多人发现决定是否进行筛查以及每年进行直肠指检或PSA检测具有挑战性，这反映出自我效能感较低。虽然参与者认识到预防措施的益处，但也报告了一些障碍，如尴尬、害怕疼痛和缺乏医生建议。值得注意的是，尽管有指南提倡对非洲裔男性进行早期筛查，但医疗保健提供者未给出筛查建议这一情况成为了一个重大差距。这些发现强调了需要采取有针对性的干预措施来提高认识、增强自我效能感、解决程序方面的问题，并鼓励医生积极参与推荐筛查，以降低前列腺癌晚期诊断的高发生率。
