Factors influencing Nigerian men's decision to undergo prostate specific antigen testing

Abstract

Background: Prostate cancer is a major cause of cancer death in Nigerian men. Attempts to reduce mortality from prostate cancer have focused mainly on early detection of the disease by the use of PSA testing. As a result of the increased incidence of prostate cancer in Nigeria despite the widespread availability of testing facilities, it became pertinent to understand the salient factors that prompt Nigerian men to go for prostate cancer testing. Objective: This study explores the factors that influence a group of Nigerian men's decision to go for Prostate Specific Antigen (PSA) testing. Methods: Following ethical approval, semi structured interviews were conducted with a group of 10 men who had PSA test following consultation with their doctor with signs and symptoms at the University of Benin Teaching Hospital from July to August, 2010. Interview transcripts were analysed by employing steps proposed by Collaizi (1978). Results: Five themes were identified: the symptoms experienced, the influence of friends and relatives, older age associated with increased awareness, accessibility to testing services and the knowledge of the PSA test. Conclusion:The study revealed that there continues to be a considerable lack of awareness and knowledge about prostate cancer and screening.

Men’s perspectives of prostate cancer screening: A systematic review of qualitative studies

“…Trusting professional opinion –Some participants had “confidence in doctors” to initiate and make recommendations about prostate cancer screening. [ 19 , 27 , 28 , 38 , 47 , 49 , 52 , 54 , 59 , 60 , 78 , 81 , 83 , 91 , 93 ] Many felt overwhelmed by the complicated medical information and thus did not feel competent enough to “evaluate the pros and cons or the risks” on their own. [ 38 , 52 ] Having a strong relationship with their health care provider allowed participants to make this important health decision for them.…”

“…Motivation from family and friends – Family and friends motivated men to be screened for prostate cancer. [ 40 , 41 , 47 , 55 – 57 , 71 , 72 , 79 , 83 , 91 , 92 , 99 ] Participants appreciated their spouses’ encouragement, their constant “nagging”[ 79 ] to pursue screening and “for sticking by”,[ 47 ] during the decision making and screening process. Having a family member who had prostate-related problems (e.g.…”

“…benign prostatic hyperplasia) also prompted them to undergo screening, as they “wouldn’t have started checking”[ 69 ] otherwise. [ 65 , 69 , 83 , 91 , 98 ]…”

“…Proximity and prominence of cancer – Participants who had seen the devastating impact of cancer among their family or friends felt acutely aware of cancer, and were prompted to undergo prostate cancer screening. [ 21 , 42 , 47 , 51 , 60 , 65 , 66 , 69 , 75 , 83 , 85 , 91 , 100 ] The death of family members due to cancer and “seeing what [they] went through”[ 51 ] as well as understanding the potential of cancer “running in the family,”[ 66 ] caused participants to become proactive about cancer screening, including for prostate cancer. Some believed their family members had cancer detected “too late”.…”

“…Survival imperative –Improving their chance of survival through early detection motivated men to undergo prostate cancer screening. [ 20 , 21 , 28 , 36 , 42 , 43 , 60 , 71 , 74 , 77 , 85 , 91 , 92 ] Early detection was perceived as imperative to prevent severe morbidity or mortality, so they could continue to live a “normal life.”[ 21 ] They believed that cancers detected early had a “higher chance”[ 20 ] of cure.…”