1
|
Graham NJ, Souter LH, Salami SS. A Systematic Review of Family History, Race/Ethnicity, and Genetic Risk on Prostate Cancer Detection and Outcomes: Considerations in PSA-based Screening. Urol Oncol 2024:S1078-1439(24)00504-0. [PMID: 39013715 DOI: 10.1016/j.urolonc.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/25/2024] [Accepted: 06/02/2024] [Indexed: 07/18/2024]
Abstract
AIM To investigate the role of family history, race/ethnicity, and genetics in prostate cancer (PCa) screening. METHODS We conducted a systematic review of articles from January 2013 through September 2023 that focused on the association of race/ethnicity and genetic factors on PCa detection. Of 10,815 studies, we identified 43 that fulfilled our pre-determined PICO (Patient, Intervention, Comparison and Outcome) criteria. RESULTS Men with ≥1 first-degree relative(s) with PCa are at increased risk of PCa, even with negative imaging and/or benign prostate biopsy. Black men have higher PCa risk, while Asian men have lower risk. Most of the differences in risks are attributable to environmental and socioeconomic factors; however, genetic differences may play a role. Among numerous pathogenic variants that increase PCa risk, BRCA2, MSH2, and HOXB13 mutations confer the highest risk of PCa. Polygenic risk score (PRS) models identify men at higher PCa risk for a given age and PSA; these models improve when considering other clinical factors and when the model population matches the study population's ancestry. CONCLUSIONS Family history of PCa, race/ethnicity, pathogenic variants (particularly BRCA2, MSH2, and HOXB13), and PRS are associated with increased PCa risk and should be considered in shared decision-making to determine PCa screening regimens.
Collapse
Affiliation(s)
| | | | - Simpa S Salami
- Department of Urology, University of Michigan, Ann Arbor, MI.
| |
Collapse
|
2
|
Jalloh M, Cassell A, Niang L, Rebbeck T. Global viewpoints: updates on prostate cancer in Sub-Saharan Africa. BJU Int 2024; 133:6-13. [PMID: 37702258 DOI: 10.1111/bju.16178] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
Prostate cancer (PCa) is a major health concern in Sub-Saharan Africa (SSA), with high incidence and mortality rates. However, the widely used prostate-specific antigen (PSA) screening is not readily available or affordable in SSA. Alternative screening strategies, such as risk stratification approaches and cost-effective PSA tests, are being explored to target high-risk individuals and improve access to screening. Diagnosis of PCa in SSA is challenging due to the lack of access to diagnostic tools and limited healthcare resources. Clinical evaluation and digital rectal examination are commonly used, but PSA testing, magnetic resonance imaging, and biopsy are often limited. As a result, many men in SSA are diagnosed at advanced stages of the disease. Treatment options for PCa in SSA are often limited by a lack of resources and trained healthcare providers. Surgery, radiation therapy, and androgen-deprivation therapy are available but may be inaccessible to many patients. Cultural beliefs and stigma surrounding PCa further impact treatment decisions. Improved patient and community awareness, electronic medical records, and communication between patients and healthcare professionals can enhance evidence-based decision-making and advocate for policy changes. Understanding the genetic determinants and implementing comprehensive strategies can lead to improved outcomes and better control of PCa in SSA.
Collapse
Affiliation(s)
- Mohamed Jalloh
- Department of Urology and Andrology, Hopital General de Grand Yoff, Dakar, Senegal
- Ecole Doctorale ED-2DS, Universite Iba Der Thiam de Thies, Thies, Senegal
| | - Ayun Cassell
- Department of Surgery, Liberia College of Physicians and Surgeons, Monrovia, Liberia
| | - Lamine Niang
- Department of Urology and Andrology, Hopital General de Grand Yoff, Dakar, Senegal
| | - Timothy Rebbeck
- Dana-Farber Cancer Institute, University of Harvard, Boston, MA, USA
| |
Collapse
|
3
|
Adus-salam A, Jimoh M, Ehiedu CG. Sexual characteristics of patients with prostate cancer seen for radiation treatment. Ecancermedicalscience 2023; 17:1577. [PMID: 37533949 PMCID: PMC10393305 DOI: 10.3332/ecancer.2023.1577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Indexed: 08/04/2023] Open
Abstract
Background Prostate cancer was estimated to be the second most diagnosed cancer and the fifth leading cause of cancer mortality among men, with an estimated 1.4 million new cases and 375,000 deaths globally in 2020. There are significant changes in sexual activities and subsequent changes in quality of life associated with the diagnosis and treatment of prostate cancer. Sexual problems experienced by prostate cancer patients include erectile dysfunction, reduced sexual desire, reduced sexual function, problems with ejaculation, as well as problems with orgasm, and these could occur before and/or after treatment. This study aims to highlight the sexual characteristics of prostate cancer patients, which would help identify altered sexuality that might require intervention by healthcare providers. Method All patients who presented with pathologically diagnosed, organ-confined prostate cancer referred for high-dose-rate brachytherapy were approached for participation in the study. An interviewer-administered questionnaire was administered to the consenting patients. Results A total of 56 patients gave consent for the study out of 60. All the patients were married, with 5 (8.9%) having multiple wives. Only ten respondents (17.9%) reported having other sexual partners besides their wives. More than half of the patients (34) (60.7%) started having sexual intercourse between the ages of 18 and 20. Many patients claimed that the diagnosis of prostate cancer had affected their sexual lives. About half of the respondents (44.6%) believed that their partners were less satisfied with their sexual performance, as evidenced by the loss of partners (5.4%), partners refusing sexual advances (14.3%), partners complaints (10.7%), and partners' reduced inclination to ask for sex (33.9%). One patient expressed fears of passing the disease to their partners. Conclusion The management of prostate cancer should include sex therapy and rehabilitation in couples from the point of diagnosis to maintain sexual function as close as possible to that in the general population in order to maintain an improved quality of life.
Collapse
Affiliation(s)
- Abbas Adus-salam
- Department of Radiation Oncology, University College Hospital/University of Ibadan, Ibadan 200212, Nigeria
- University College Hospital, Ibadan 200005, Nigeria
| | - Mutiu Jimoh
- Department of Radiation Oncology, University College Hospital/University of Ibadan, Ibadan 200212, Nigeria
- University College Hospital, Ibadan 200005, Nigeria
| | | |
Collapse
|
4
|
Benedict MO, Steinberg WJ, Claassen FM, Mofolo N. The profile of Black South African men diagnosed with prostate cancer in the Free State, South Africa. S Afr Fam Pract (2004) 2023; 65:e1-e10. [PMID: 36744484 PMCID: PMC9983285 DOI: 10.4102/safp.v65i1.5553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/06/2022] [Accepted: 06/24/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Prostate cancer (PCa) ranks high in terms of morbidity and mortality, especially in Africa. Prostate-specific antigen (PSA) screening remains a practical method of screening for and thereby detecting PCa early, especially among African men who are more negatively affected. Modifiable risk factors for PCa are mostly behavioural and lifestyle. Understanding community-specific determinants is important when developing health promotion interventions. OBJECTIVE This study aimed to determine the profile of African men with PCa in the Free State, South Africa. METHOD A cross-sectional descriptive study was conducted using case record information and self-administered questionnaires among 341 African men with PCa attending the oncology and urology clinics of a tertiary hospital. RESULT Participants' median age at diagnosis was 66 years. Only 76 (22.3%) participants had ever heard of PCa prior to being diagnosed with the disease, 36 (47.4%) of whom had ever had screening performed. The majority (n = 298, 87.4%) were symptomatic; 50% sought medical help within six months. At diagnosis, 133 (39.0%) men presented with stage T3 or T4 disease, 75 (22.0%) with metastatic disease and 84 (24.6%) with Gleason score ≥ 8. Factors associated with advanced and high-grade disease included smoking, decreased sunlight exposure and physical activity, relatively increased ingestion of dairy products and red meat. Factors associated with early stage and low-grade disease included relatively increased ingestion of fruits, vegetables and fish. CONCLUSION Advanced and high-grade PCa disease is not uncommon among men ≥ 60 years in this study setting. Certain modifiable risk factors associated with advanced disease were established in this study. The majority had lower urinary tract symptoms (LUTS) prior to PCa diagnosis, but they were of poor health-seeking behaviour. Although there seems not to be a systematic delay in the definitive diagnosis and initiation of treatment for PCa, there is a need to improve on health education and awareness in the study setting.
Collapse
Affiliation(s)
- Matthew O.A. Benedict
- Department of Family Medicine, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein, South Africa
| | - Wilhelm J. Steinberg
- Department of Family Medicine, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein, South Africa
| | - Frederik M. Claassen
- Department of Urology, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein, South Africa
| | - Nathaniel Mofolo
- Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein, South Africa
| |
Collapse
|
5
|
Benedict MO, Steinberg WJ, Claassen FM, Mofolo N. The profile of Black South African men diagnosed with prostate cancer in the Free State, South Africa. S Afr Fam Pract (2004) 2022. [DOI: 10.4102/safp.v64i1.5553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|
6
|
Ezenwankwo EF, Nnate DA, Oladoyinbo CA, Dogo HM, Idowu AA, Onyeso CP, Ogo CN, Ogunsanya M, Bamidele O, Nnaji CA. Strengthening Capacity for Prostate Cancer Early Diagnosis in West Africa Amidst the COVID-19 Pandemic: A Realist Approach to Rethinking and Operationalizing the World Health Organization 2017 Guide to Cancer Early Diagnosis. Ann Glob Health 2022; 88:29. [PMID: 35646616 PMCID: PMC9104562 DOI: 10.5334/aogh.3519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Two years after SARS-CoV-2 (COVID-19) was declared a global public health emergency, the restoration, at least, to the pre-pandemic level of early diagnostic services for prostate cancer has remained enormously challenging for many health systems, worldwide. This is particularly true of West Africa as the region grapples also with the broader impacts of changing demographics and overly stretched healthcare systems. With the lingering COVID-19 crisis, it is likely that the current trend of late prostate cancer diagnosis in the region will worsen with a concomitant increase in the burden of the disease. There is, therefore, a compelling need for innovative and evidence-based solutions to de-escalate the current situation and forestall the collapse of existing structures supporting early prostate cancer diagnosis in the region. In this viewpoint, we make a case for the operationalization of the World Health Organization (WHO) guide to early cancer diagnosis to strengthen the capacity for early prostate cancer diagnosis in West Africa using a realist approach, drawing on participatory health research and evidence-based co-creation. Ultimately, we demonstrate the potential for developing COVID-19 responsive and context-specific models to optimize patient navigation/journey along the essential steps of the World Health Organization guide to early cancer diagnosis.
Collapse
Affiliation(s)
- Elochukwu Fortune Ezenwankwo
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa
- African Behavioral Research (ABeR) Center, Federal University of Agriculture, Abeokuta, Nigeria
- Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa
| | - Daniel A. Nnate
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, UK
| | - Catherine Adebukola Oladoyinbo
- African Behavioral Research (ABeR) Center, Federal University of Agriculture, Abeokuta, Nigeria
- Department of Nutrition and Dietetics, Federal University of Agriculture, Abeokuta, Nigeria
| | - Hassan Mohammed Dogo
- African Behavioral Research (ABeR) Center, Federal University of Agriculture, Abeokuta, Nigeria
- Department of Surgery, Urology Division, University of Maiduguri, Maiduguri, Nigeria
| | - Ademola Amos Idowu
- African Behavioral Research (ABeR) Center, Federal University of Agriculture, Abeokuta, Nigeria
- Department of Chemical Pathology, Ekiti State University College of Medicine, Ado-Ekiti, Nigeria
| | | | - Chidiebere Ndukwe Ogo
- Department of Surgery, Federal Medical Centre Abeokuta, NG
- African Behavioral Research (ABeR) Center, Federal Univeristy of Agriculture, Abeokuta, Nigeria
| | - Motolani Ogunsanya
- College of Pharmacy, University of Oklahoma Health Sciences Center, 1110 N. Stonewall Ave, Oklahoma City, US
| | - Olufikayo Bamidele
- Institute for Clinical and Applied Health Research, Hull York Medical School, R341, University of Hull, UK
| | - Chukwudi A. Nnaji
- Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa
- Cochrane South Africa, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town 7501, South Africa
| |
Collapse
|