Prostate cancer clinicopathological presentation in South-East Africa during the 2010 decade

Abstract

Prostate cancer (PCa) is the leading cause of cancer-associated death amongst men across Sub-Saharan Africa, with Southern and East Africa ranking 1st and 5th globally. However, lack of coordinated National cancer registries has biased data towards single sourced, averaged or model estimates. Here, our retrospective study included 8,634 South-East African cases diagnosed between 2010-to-2019, which when compared with 71,694 Black and 322,356 White period-matched Americans, were over 3-fold more likely to present with aggressive disease (International Society of Urological Pathology grade groups ≥4: 45.38% vs 21.22% and 21.05%; Prostate Specific Antigen ≥20 ng/mL: 62.04% vs 17.29% and 11.17%, respectively; all two-sided P<0.0001). While East over Southern Africans are 1.5-times more likely to present with advanced disease, age was not a confounder. Supporting PCa as a major health concern for Africa, our data suggests underestimation in East Africa, while highlighting the need for accurate monitoring, increased awareness, and tailored screening criteria.

Keywords: Prostate cancer presentation; South-East Africa; health disparities; high-risk disease.