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Initial Prostate Specific Antigen (PSA) Test can be used to Reduce the Burden Associated with Prostate Cancer Screening in High Risk Populations

Ntekim A

Background: There is high mortality from prostate cancer in Nigeria. Lack of awareness and low screening uptake are associated with this poor outlook. There is need to develop strategies to improve uptake of screening to ensure early diagnosis for men with prostate cancer in our environment.

Objectives: The objective of the study was to determine the proportion of men with initial PSA values ≥ 2.5-4 ng/mL who will be eligible for yearly follow up screening in high-risk prostate cancer population.

Methods: This was a cross sectional study carried out among men from two worship centres in Ibadan Nigeria (A church and a mosque). Participants were educated on prostate cancer and the characteristics of PSA based screening before consent was obtained from individuals for participation. Self-administered questionnaires were completed before blood samples were obtained for PSA analysis. Digital rectal examinations were carried out among participants.

Findings: All the 97 participants aged between 40 to 72 years who turned up for the exercise gave consent to participate. Complete data was available for 81 participants included in the final analysis. Five (6.25%) out of the 81 participants analyzed heard about prostate cancer and PSA testing but none has ever undergone PSA based screening. Total PSA values ranged from 0.064 ng/mL to 41.427 ng/mL with one outlier having a value of >100 ng/mL. Sixty-nine (86.25%) participants had PSA values < 2.5 ng/mL, 7 (8.75%) had values ≥ 2.5-4 ng/mL while 4(5%) had values greater than 4 ng/mL.

Conclusion: Low number of participants (9%) had PSA values ≥ 2.5-4 mg/ml requiring yearly follow up screening. Sorting of men based on initial PSA results can reduce the number of those for yearly screening leading to the reduction in the burden associated with PSA based screening.