Factors Influencing Help-Seeking Behavior in Men with Symptoms of Prostate Cancer: A Qualitative Study Using an Ecological Perspective

Strengthening Capacity for Prostate Cancer Early Diagnosis in West Africa Amidst the COVID-19 Pandemic: A Realist Approach to Rethinking and Operationalizing the World Health Organization 2017 Guide to Cancer Early Diagnosis

“…In our recent study, we showed that lack of prostate cancer knowledge and symptom awareness are the major determinants of poor health-seeking behavior (at the individual level) [25]. Men with a low prostate cancer awareness were most likely to prolong symptom appraisal interval, interpret symptoms wrongly, and delay help-seeking [31].…”

“…Limited access to care can also result from fatalistic beliefs and dysfunctional social/cultural norms. In Nigeria, fatalism has led many men to seek alternative care either from "faith-based centers" or traditional healers [25]. Fear of embarrassment, stigmatization, financial constraints, poor transport systems, past unpleasant hospital/medical experience, and lack of family support are other factors that have impacted negatively on men's health-seeking behavior and restricted access to care [25].…”

“…In Nigeria, fatalism has led many men to seek alternative care either from "faith-based centers" or traditional healers [25]. Fear of embarrassment, stigmatization, financial constraints, poor transport systems, past unpleasant hospital/medical experience, and lack of family support are other factors that have impacted negatively on men's health-seeking behavior and restricted access to care [25]. Efforts to increase early prostate cancer diagnosis in West Africa must include culturally relevant strategies for mitigating these barriers.…”

“…Currently, several hospital-based studies are reporting between 33% and 50% of metastatic disease at diagnosis at a time when evidence is showing that nations with higher levels of emergency diagnoses have lower survival for most cancers [10,13,10,21,22,23]. Coupled with a growing incidence of late-stage prostate cancer diagnosis, the region, like the rest of sub-Saharan Africa is increasingly affected by more aggressive forms of the disease, with a higher likelihood of experiencing faster disease progression and worse survival outcomes [10,14,15,24,25]. With a cumulative risk-adjusted mortality of 2.13, deaths from prostate cancer in West Africa are among the highest in the world [14].…”

“…With a cumulative risk-adjusted mortality of 2.13, deaths from prostate cancer in West Africa are among the highest in the world [14]. Even as the roles of biological, sociodemographic, environmental, and behavioral factors underlying this trend have been speculated [10,26], the current situation is complicated largely by health systems inadequacies typified by limited access to early diagnosis and substandard treatments [14,15,25]. Access to definitive diagnostic modalities such as biopsy or tumor staging is highly limited, as is access to both definitive and non-curative treatment options [10,13].…”