High-grade intra-epithelial neoplasia and prostate cancer in Dibombari, Cameroon

Abstract

High-grade prostatic intra-epithelial neoplasia (HGPIN) occurs a decade earlier in men of African descent in the US and Brazil, compared to white men. Prostate cancer incidence and mortality is worse in the African-American than in US white men. Sub-Saharan Africa was thought to be a low incidence area. This disparity has been attributed to lifestyle factors such as diet. We report the results of prostatic biopsies, from an ongoing national prostate cancer survey. One hundred and eleven men aged 40 y and over were recruited for medical interview (AUA symptom score), prostate specific antigen (PSA) assay and digital rectal examination (DRE). Between six and 10 cores of random digitally guided needle biopsies were performed on 24 subjects that had either suspicious prostates on digital rectal examination þ / or PSA 4 ng/ml. All lesions of the prostate were described on routine histopathology. The Gleason score and proportion of tissue involved with cancer, was determined. Eight men had benign prostatic hyperplasia (BPH), six had cancer, another six had low grade intra-epithelial neoplasia, two had HGPIN, there was one case of BPH and chronic prostatitis and one case of chronic prostatitis only. The cancer patients were aged 58 -75 y (mean 66.93 y). Gleason scores ranged from 5 to 9, there was one score of 3. Cancer made up 20 -80% tissue samples. HGPIN was found in two cases (mean age 58 y). Significant prostate cancer and the pre-cancerous lesion HGPIN exist in Dibombari, Cameroon. The purported low incidence of prostate cancer may reflect cultural and economic barriers to health care.

A Discrete Choice Clinical Survey and a Proposed Health Promotion Framework for Prostate Cancer in Cameroon

“…This study revealed a prevalence of prostate cancer of 10.4%, which support the hypothesis that there is a relatively high prevalence of prostate cancer in Bamenda, North West Region of Cameroon. This prevalence was similar to the prevalence of a research conducted in Ghana in 2015 with a prevalence of 9.4% [15][16][17][18][19][20][21] and that conducted in Dibombari, Cameroon with a prevalence of 8.0% [22]. However, this study revealed a relatively high prevalence of prostate cancer as opposed to previous research work conducted in Ghana with a prevalence of 7.0% [23] which could be as a result of difference in the methodology used.…”

High-grade prostatic intraepithelial neoplasia

“…21,[35][36][37] African-American men also have the highest incidence of prostate cancer (about 50% more than Caucasians). 21,35,36,38,39 In contrast, Japanese men living in Osaka, Japan, have a significantly lower incidence of high-grade PIN compared to men residing in the United States, and Asians have the lowest clinically detected rate of prostate cancer. 40,41 Interestingly, Japanese men diagnosed with high-grade PIN also had an increased likelihood of developing prostate cancer, suggesting that high-grade PIN is a precursor of clinical prostate cancer in Asian men too.…”

High-grade prostatic intraepithelial neoplasia

“…21,[35][36][37] African-American men also have the highest incidence of prostate cancer (about 50% more than Caucasians). 21,35,36,38,39 In contrast, Japanese men living in Osaka, Japan, have a significantly lower incidence of high-grade PIN compared to men residing in the United States, and Asians have the lowest clinically detected rate of prostate cancer. 40,41 Interestingly, Japanese men diagnosed with high-grade PIN also had an increased likelihood of developing prostate cancer, suggesting that high-grade PIN is a precursor of clinical prostate cancer in Asian men too.…”