Predictors of late diagnosis of prostate cancer among men of African ancestry receiving care at urology clinic, Federal Medical Centre, Abeokuta

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.