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A Discrete Choice Clinical Survey and a Proposed Health Promotion Framework for Prostate Cancer in Cameroon

Kenneth Yongabi Anchang, Kyeng Mercy Tetuh, Christopher Achu Nji, Bame Sixtus, Angu Gideon Ndegeh

Background: Due to the dearth of information about the burden of prostate cancer disease in Cameroon, and in respond to the Sustainable Development Goal (SDG#3) to prevent non-communicable diseases, a discrete choice clinical study of prostate cancer with the aim to determine the incidence, the associated risk factors and comparative diagnostic tools among males in the North- West region of Cameroon was undertaken.

Methodology: A cross-sectional simple random sampling was conducted on 231 male volunteers from five health communities in Bamenda, aged ≥ 40 years. A structured questionnaire was issued to participants prior to screening through which demographic and lifestyle information was gotten. Serum free Prostate Specific Antigen (PSA) was analyzed and digital rectal examination (DRE) performed by a license medical doctor during routine consultation at the Phyto-biotechnology Research Foundation (PRF) integrated centre via an exit poll. The diagnostic criteria stated as PSA value greater than 4 ng/ml or if digital rectal examination was suspicious for cancer. Biopsy was not done.

Results: Out of the 231 men who consented via an exit poll, 45 (19.5%) had a PSA value greater than 4 ng/ml and 68 (28.1%) had a suspicious digital rectal examination. There was a statistical significance between PSA and DRE with a p=0.001. Furthermore, 22 (9.5%) of the males had a PSA of greater than 4 ng/ml and a suspicious DRE. A statistical significance was also established between PSA and DRE with age groups with a p=0.007 and a p=0.001 respectively. No statistical significance was seen with family history of cancer, type of underwear, bicycle riding and physical exercise.

Conclusion: The study indicated less than 50% prevalence rate for the men screened, but the 28.1% prevalence level going by DRE may suggest the growing incidence of prostatitis and or benign prostate hyperplasia. Although biopsies are considered the ideal routine observation, this study suggests that PSA marker and DRE determination can be used in combination with clinical features to make appropriate diagnostic decision on prostate cancer in resource limited communities.

Recommendation: A health promotion framework involving individuals and communities in Cameroon on the awareness and risk factors associated with prostate cancer for men above forty in Cameroon are future preventive measures to embark upon.