Prostate cancer screening uptake and predictors of elevated prostate-specific antigen levels in Southwestern Nigeria.

Abstract

403 Background: Prostate cancer is the most commonly diagnosed malignancy among men in Nigeria, yet uptake of prostate-specific antigen (PSA) testing remains low, contributing to late-stage diagnosis and poor outcomes. There is limited community-based data on screening uptake and factors influencing PSA levels among Nigerian men. This study aims to assess the uptake of PSA testing, identify factors influencing screening uptake, and evaluate risk factors associated with elevated PSA levels in a Nigerian community. Methods: We conducted a community-based cross-sectional study in Ilesa West, Osun State, Nigeria, among men aged 40 years and above. Participants completed a questionnaire, and blood samples were collected for PSA testing. PSA levels of ≥ 4.0 ng/mL were considered elevated. We used Chi-square tests and Pearson correlation for analysis. Results: Among 81 participants (55.30 ± 11.02 years), only 2.5% had ever undergone PSA testing, while 11.1% were aware of prostate cancer. Awareness of PSA testing was significantly associated with prior PSA testing (p<0.05). Findings also indicated that employment status (p=0.011) and marital status (p=0.033) were significantly associated with prior PSA testing. Elevated PSA levels (≥4 ng/mL) were observed in 21% of the participants. About just 17.3% had a past surgical history, 33.3% had lower urinary tract symptoms (LUTS), and 45.7% had at least a co-existing chronic disease. LUTS were significantly (p<0.05) associated with PSA levels. Furthermore, PSA levels showed a significant positive correlation with age (r=0.408, p<0.01). Conclusions: PSA testing uptake in this Nigerian community is alarmingly low despite a notable proportion of men having elevated PSA levels. Older age and LUTS were significant predictors of elevated PSA, highlighting opportunities for targeted screening. Interventions incorporating health education, integration of prostate cancer screening into primary care, and subsidized services are urgently needed to improve early detection and reduce prostate cancer mortality in Nigeria.