Uptake of Prostate Cancer Screening and Associated Intra-Personal Factors among Men Aged 40-69 Years: A cross-sectional study in a rural community in Kenya

Abstract

 Prostate Cancer (PC) is mostly asymptomatic despite mortality rate highly dependent on early diagnosis and treatment which might have been hindered by existing barriers. By the year 2018, PC ranked second globally among the most diagnosed cancers in males attributing to 13.5% of deaths. Disparities existed regarding the mortality rates of PC with a slight predominance in blacks compared to other races. The level of PC screening in Kenya like any other Sub-Sahara African country was terribly low [2-,10]. A community-based study carried out in a rural area reported only 2.4% of the participants had been screened, while in the capital city of Kenya (Nairobi City County), only 4.1% of the respondents had ever been screened.

Objective : The aim of the study was to determine the intra- personal factors influencing uptake of prostate cancer screening among men aged 40-69 years in Kiambu County, Kenya.

Methodology: In April 2019, the study adopted a descriptive cross-sectional survey design in Kiambu County. A total of 576 men aged between 40-69 years except those already diagnosed with prostate cancer from the Community units within Gatundu North and Kiambu Sub- counties were recruited. Data was collected through an interviewer-administered questionnaire. It was coded, cleaned and analyzed using Statistical Package of Social Sciences (SPSS) version 22. Bivariate analysis with Pearson’s chi -square test was used to compare the proportions. A P-value of <0.05 was considered statistically significant at 95% Confidence Interval. The significant variables were then subjected to Multi-variate logistics regression for further analysis of the association with uptake of screening of Prostate Cancer. Participant’s autonomy and anonymity was maintained, and any information shared by them was confidential.

Results : The level of screening was low. Only 5% of the respondents had ever been screened for prostate cancer. Socio-demographic factors were not associated with prostate cancer screening but Socio-economic factors made an impact. Owning 1-3 acres of land was significantly associated with screening. Respondents who owned 1-3 acres were 15 times more likely to take up screening in comparison with those having less than 1 acre of land. [OR =15.672 CI 95% (1.256- 195.47) P=0.033] CONCLUSION

The level of prostate cancer screening was low. Socio- economic factors were found to influence uptake of prostate cancer screening. Socio-economic factors when designing prostate cancer prevention programs need to be emphasized. Prostate Cancer screening remained a controversial issue due to the documented risk of over diagnosis and harm associated with biopsy and treatment in developed countries.

Recommenations : An early diagnosis of Prostate cancer will give an opportunity for treatment. Preventive Services Task Force report recommends the screening of men for PC among those considered at risk within the age of 40-69 years through shared a decision-making process.

Key words: Prostate cancer, Prostate-Specific Antigen, Screening, Kenya