Prostate cancer screening: what do men know, think and do about their risk? exploring the opinions of men in an urban area in Lagos State, Nigeria: a mixed methods survey

INTRODUCTION: Prostate cancer (PCa) is the leading cause of cancer-related deaths in men aged 40 years and older. Incidence and mortality rates are higher in African men. PCa is amenable to early detection by screening which can prevent and reduce cancer deaths. Late-stage presentation and diagnosis often occur due to poor screening practices. This study assessed the knowledge, attitude, prevalence and barriers towards PCa screening among males in an urban area in Nigeria using a mixed method approach. METHODS: This cross-sectional descriptive study used quantitative and qualitative methods among men aged 40 years and older. A pretested structured questionnaire was used to interview 344 respondents through multi-stage sampling. Additionally, two focus group sessions were held using a pre-tested guide. RESULTS: Respondents were between 40-89 years with a mean age of 52.8 ± 9.9 years. Majority (54.9%) had poor knowledge of prostate cancer and its screening methods however, 65.7% expressed positive attitudes towards screening. Only 73 (21.2%) had ever been screened. The focus groups showed that respondents expressed a willingness to undergo PCa screening. The main barriers to screening were the fears of a positive result, ignorance and financial constraints. Participants preferred male physicians during digital rectal examinations. CONCLUSION: Respondents showed poor levels of knowledge. They expressed positive attitudes towards screening. However, this was not translated into practice. Public health interventions should educate men about benefits of early detection while addressing fears of positive findings and gender biases during rectal examinations. Efforts at providing low-cost alternatives for PCa screening are needed.