Prostate cancer screening: assessment of knowledge and willingness to screen among men in Obio Akpor LGA, Rivers State, Nigeria

Prevalence and antibiotic susceptibility patterns of uropathogens in men with prostate cancer and benign prostate hyperplasia from Southwestern Nigeria

BACKGROUND

Epidemiological investigations have revealed an important association between infection, inflammation and prostate cancer. Certain bacterial species, such as Klebsiella spp, Escherichia coli, Pseudomonas spp, Proteus mirabilis, Chlamydia trachomatis have been linked to prostate cancer. This study aimed to examine the microbiota; specifically bacterial species that have been linked to prostate infections in the urine of individuals diagnosed with prostate cancer.

RESULTS

Sixty-six prostate cancer patients and forty controls provided midstream urine samples. The urine samples were grown on suitable medium, and bacterial isolates were detected by standard microbiological methods. Additionally, the antibiotic sensitivity pattern of the bacterial isolates was analysed. A total of number of 72 bacterial isolates were obtained from the urine of study participants. The results showed the presence of Escherichia coli (50.0%), Pseudomonas aeruginosa (18.1%), Klebsiella spp (15.3%), Staphylococcus aureus (8.3%), Enterobacter spp (4.2%), and Proteus mirabilis (2.8%) in the urine. The most common bacterial species isolated from prostate cancer patients was Escherichia coli, which was susceptible to levofloxacin (100%), tobramycin (91.7%), and amikacin (62.5%).

CONCLUSIONS

This study's findings established the presence of bacteria previously linked to prostatitis. This report indicates a high prevalence of pro-inflammatory bacteria and uropathogens in the urinary tract of men diagnosed with prostate cancer.

Prostate cancer characteristics: A descriptive analysis of clinical features at presentation in the last decade in a black African community

Background:

Prostate cancer, previously reported as relatively rare in Nigeria, is currently the leading cancer and leading cause of cancer-related death in men. Late presentation appears to persist despite higher incidence rates and instituted awareness programs. This study assesses current prostate cancer indices at presentation to a 3^rd tier referral hospital in South-east Nigeria and compares these indices with reported indices from previous decades.

Materials and Methods:

Retrospectively, the medical records of men presenting with histologically confirmed prostate cancer from January 2009 to April 2018 were reviewed. Age, spectrum and duration of clinical features, serum total prostate-specific antigen (tPSA), and prostate biopsy specimen Gleason Score (GS) at presentation were retrieved for the analysis using the SPSS software version 21. Obtained mean values and proportions were compared to reports from previous decades for observable shifts.

Results:

The medical records of 331 men 51–90 years of age (mean: 69.8 ± 8.0 years) were retrieved. Six (1.8%) men (median tPSA = 28.0 ng/ml; range 10.0–121.4 ng/ml) had screening-detected prostate cancer. About 72.0%, 52.0%, and 30.3% of men present with symptoms after 3 months, 6 months, and 12 months, respectively, and about 55.1% had other clinical features of disease progression beyond lower urinary tract symptoms. Symptom duration, serum tPSA (median 31.4 ng/ml; range 4.0–710.0 ng/ml), and % fPSA (median 20.6%; range 57.1%–8.6%) at presentation, as well as prevalent poorly-differentiated tumor (GS ≥7 [4 + 3] 62.2%) are yet to shift from reports from previous decades.

Conclusions:

Prostate cancer indices at presentation in South-eastern Nigeria, a resource-poor community in sub-Saharan Africa are yet to positively shift despite efforts at prostate cancer awareness.

Prostate cancer knowledge gaps among community stakeholders in rural Nigeria: implications for seeking screening

PURPOSE

In Nigeria, knowledge about prostate cancer (PCa) is poor, so are the availability, accessibility, and utilization of PCa screening services. Poor knowledge increases the burden of disease, this is more so in rural settings. PCa, being gender-specific, has underlying cultural connotations. There is a dearth of evidence on the rural-cultural understanding of PCa onset. The study examined community stakeholders' knowledge, risk perception, as well as the perceived barriers to seeking PCa screening. Rosenstock's Health Belief Model provided the theoretical framing for the study.

METHODS

The study design was descriptive and a cross-sectional approach to the social constructionist ideas of the qualitative tradition was adopted. There were twenty-one interviews with purposively selected community stakeholders; Fourteen key informant (traditional healers and medical doctors) interviews and seven In-depth Interviews (traditional leaders) held in the Ijebu culture cluster of Ogun State, Nigeria. Narratives were analyzed based on the following theoretical themes: knowledge, risk perception, and perceived barriers to PCa screening. These themes derived their structures from content-analyzed findings.

RESULTS

Results show that traditional healers and leaders have limited scientific knowledge of PCa etiology. Folk beliefs form the basis of PCa knowledge among most stakeholders. However, all stakeholders consider PCa a threat to men. The cultural sense of 'maleness' and access to appropriate information about PCa are essential approaches to establishing perceived threat/susceptibility. Cancer health education and distance of screening facilities are primary barriers to seeking screening.

CONCLUSION

Stakeholders' knowledge of PCa and PCa screening should be improved by educating them and developing integrative community engagement strategies.