Prostate cancer awareness and screening among men in a rural community in Kenya: a cross-sectional study

Abstract
Background
Globally, prostate cancer ranks as the second most frequently diagnosed cancer among men with the highest mortality rates being in Asia and Africa. The screening rates have been very low among men from developing countries with the majority presenting in advanced stages of the disease. The study aimed to assess the awareness of prostate cancer and screening among men aged 40–69 years in a rural community in Kenya.

Methods
This cross-sectional mixed-method survey was conducted among men aged 40–69 years. Data were collected using a pretested questionnaire among 576 men and a Focus Group Discussion guide among 44 men. The study was conducted in all the community units in Gatundu North and Kiambu Sub-counties, Kenya.

Results
Five hundred and seventy-six men participated with a response rate of 100%. Of the men interviewed, 84% had ever heard of prostate cancer. Slightly below half (40.6%) of the respondents had ever heard of prostate cancer screening. There was the existence of myths and misconceptions which predominantly associated prostate cancer with sexual behaviors. Overall, 57.3% of the respondents had a low level of awareness of prostate cancer. The prevalence of prostate cancer screening was 5%. Willingness to undergo screening in the future was high (81%) among the participants. The most frequently cited (56.9%) reason for lack of willingness to screen was the participant’s belief that they were well. Participants who were aware of prostate cancer screening were more likely to take up screening (OR = 8.472; 95% CI: 1.554- 46.186; P = 0.014).

Conclusion
Awareness of prostate cancer symptoms, treatment, and screening was low with the existence of myths and misconceptions. The level of prostate cancer screening was abysmally low. It is vital for the Ministry of Health, county governments, and other stakeholders to consider the use of multifaceted approaches to increase public awareness on prostate cancer to enhance informed shared decision making. The study provides relevant information for designing prevention and control programs for prostate cancer.