Abstract 5955: A decade of discovery: Unveiling the prevalence, patient characteristics and histopathologic features of early-onset prostate cancer at a West African tertiary institution

Abstract BACKGROUND: Prostate cancer is commonly regarded as a disease that affects older men, with the average age of diagnosis being 66 years. A notable rise has been seen among men aged 55 years and below (early onset). This demographic shift, particularly pronounced in Sub-Saharan Africa highlights the urgent need for targeted research. The study aimed to determine the prevalence and describe the patient characteristics and histopathologic features associated with prostate cancer in focusing on a demographic that has been relatively underrepresented in prostate cancer research. DESIGN: A retrospective descriptive study was conducted to evaluate histologically confirmed cases of prostate cancer in men aged 55 years and below at the National Radiotherapy, Oncology, and Nuclear Medicine Centre at the Korle Bu Teaching Hospital in Accra. We used secondary data from medical records over 10 years (2013 to 2022). Data were analyzed using STATA 14. RESULTS: There were 81 cases of prostate cancer in men aged 55 years and below, comprising 4.5% of all prostate cancers diagnosed over 10 years. The average age at diagnosis was 52 years, ranging from 38 to 55 years. Of these, 98.8% were adenocarcinomas, and 1.2% represented a spindle cell sarcoma. Regarding the Gleason scores, most patients (53.1%) had a primary Gleason grade of 3, followed by 32.1% with a grade of 4. A smaller proportion had grades 5 or 2, and 3.7% of records did not report the primary Gleason grade. The most common secondary Gleason grade was also 3, found in 53.1% of cases, followed by grade 4 in 33.3%. Fewer patients had secondary grades of 5 or 2, and 2.5% of records lacked this information. Grade group 1 accounted for the most frequent pattern, observed in 41.8% of the cases, followed by grade group 4 in 16.5% of cases. The rest of the grade groups, including 2, 3, and 5, were present less frequently. Out of the 81 patients, the majority (48.15%) had evidence of perineural invasion, while 41.98% did not. A small percentage of records (9.88%) did not state whether perineural invasion was present. Interestingly, there was evidence of metastasis in 23.5% of the patients. The most frequently involved metastatic sites were the thoracolumbar vertebrae (14.9%), femur (12.8%), pelvis (12.8%), and liver (8.5%). CONCLUSION: Given the distinct clinical features and the relatively high prevalence of metastasis in this age group, further research is needed to better understand the underlying biology of early-onset prostate cancer and to devise tailored diagnostic and therapeutic regimen for this unique cohort. Citation Format: Patience Obiorkor Commey. A decade of discovery: Unveiling the prevalence, patient characteristics and histopathologic features of early-onset prostate cancer at a West African tertiary institution [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 5955.