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Knowledge, Attitudes and Practices Towards Prostate Cancer
Screening Amongst Men Aged 40-60 Years in The Buea Health
District: A Cross-Sectional Study
Ngende Rosine
1
, Divine Enoru Eyongeta
2
, Cyril Kamadjou
3
, Ghislain Dema
4
, Ngwa Fred Ngunjoh
5
,
Asu
Carine Ndum
6
Tendongfor Nicholas
7
1
Department of Public Health, Faculty of Health Sciences, University of Buea, Buea, Cameroon
2
Department of Surgery and Specialities, Faculty of Health Sciences, University of Buea, Buea,
Cameroon
3
Saint Cyr Endoscopy Urology Centre, Bonapriso, Douala, Douala, Cameroon
4
Department of Public Health, Faculty of Health Sciences, University of Buea, Buea, Cameroon
5
Department of Public Health, Faculty of Health Sciences, University of Buea, Buea, Cameroon
6
Department of Public Health and Administration, Faculty of Health Sciences, Buea, Biaka University
Institute of Buea, Cameroon.
7
Department of Public Health, Faculty of Health Sciences, University of Buea, Buea, Cameroon
DOI: https://doi.org/10.51244/IJRSI.2025.120800050
Received: 25 July 2025; Accepted: 01 Aug 2025; Published: 03 September 2025
ABSTRACT
Background: Prostate cancer is a significant global health burden, particularly in low- and middle-income
countries where late diagnosis is common. It is the second most diagnosed cancer among men and contributes
substantially to cancer-related deaths. In Cameroon, prostate cancer is the second most deadly cancer among
men, highlighting the need for improved awareness and screening practices.
Objective: The objective of the study was to assess knowledge, attitudes and practices towards prostate cancer
screening among men aged 40-60 years in the Buea Health District.
Method: A cross-sectional study was conducted in the Buea Health District, Cameroon, from February 2024
to May 2024. A multi-stage sampling method was used to recruit 314 men aged 40-60 years. Data were
collected using a structured questionnaire and analyzed using SPSS version 26.0.
Results: The study revealed that 62.74% of participants had poor knowledge on prostate cancer, while 50.32%
exhibited positive attitudes towards screening. However, only 3.18% reported good practices regarding
screening. Participants from Molyko were 4.637 times more likely to have poor knowledge (AOR = 4.637; CI:
0.79-6.28; p < 0.001). Participants from Molyko were significantly more likely to have a positive attitude
(AOR = 18.556; CI: 6.897-20.944; p < 0.001). Secondary education level (AOR = 2.807; CI: 0.327-3.865; p =
0.004) and being aged 40–49 years (AOR = 0.467; CI: -1.335-0.972; p = 0.009) were also significant
predictors. Self-employed participants were significantly less likely to have poor practices (AOR = 0.046; CI: -
5.00-0.250; p = 0.002). Participants aged 40–49 years were more likely to have poor practices compared to
those aged 50–60 years (AOR = 5.828; CI: 0.13-9.39; p = 0.034).
Conclusion: Most participants had poor knowledge and practices but a relatively positive attitude towards
prostate cancer screening. Key predictors of KAP included health area, income, education level, employment
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status, and age group. Targeted educational and behavioral interventions are needed to bridge knowledge gaps
and improve screening practices.
Key words: Attitudes, Knowledge, Practices, Prostate cancer screening
INTRODUCTION
Prostate cancer is a malignancy that affects most adult males globally and has a devastating impact if not
discovered early. It is currently regarded as the second most diagnosed type of cancer and contributes to the
increasing death rates in adult males [1]. Non communicable diseases are responsible for about 70% of all
deaths worldwide with majority of these deaths occurring in the low and middle income countries. Prostate
cancer remains the most commonly diagnosed non- cutaneous cancer. Incidence rates increase drastically over
the age of 65 years with mortality rates increasing rapidly over the age of 70 [2].
According to the Global Cancer Observatory (GLOBOCAN) report of 2020, about 1,414,259 new prostate
cancer cases were reported in 2020, representing 7.3% of all cancers worldwide. It explained that the mortality
due to prostate cancer is estimated to be 375,304, representing 3.8% of all cancer deaths globally. Prostate
cancer is an important health burden among men worldwide with the highest incidence rates being in sub-
Saharan Africa [2].
Prostate cancer incidence increases with age. Although only 1 in 350 men under the age of 50 years are
diagnosed with prostate cancer, the incidence rate increases up to 1 in every 52 men for ages 50 to 60 years.
The incidence rate is nearly 60% in men over the age of 65 years. The worldwide variations in prostate cancer
incidence might be attributed to PSA testing [3].
According to the WHO, cancers are the fifth largest killer and non-communicable disease with a mortality rate
of about 3%. The annual incidence would be 15 thousand new cases and its prevalence estimated at 25
thousand cases. The most deadly cancers in Cameroon are cancer of the cervix, breast, lung and prostate. Of
these cancers, prostate cancer is the second most deadly cancer in men in Cameroon. It is responsible for
23.5% of deaths recorded for all human cancer deaths in the country [4].
Prostate cancer is the fourth leading cancer-related cause of death worldwide and the second most common
cancer among men. An estimated 1.1 million men worldwide were diagnosed with prostate cancer in 2012,
accounting for 15% of the cancers diagnosed in men. The burden of prostate cancer is expected to grow to 1.7
million new cases and 499,000 new deaths by year 2030. Various epidemiological data have supported the
high incidence and mortality of this malignancy amongst the blacks. In contrast to high-income countries,
where mortality rate is low as a result of routine screening leading to early detection, majority of the cases in
low and middle-income countries like Cameroon are diagnosed among symptomatic men at advanced stages
with higher mortality rates [5].
MATERIALS AND METHODS
Study Design and population
A cross-sectional study was conducted in the Buea Health District (BHD), located in the South West Region of
Cameroon from February, 2024 to May 2024. The study population was men aged 40-60 years in the Buea
Health District.
Study Area
The study was conducted in the Buea Health District (BHD), located in the Southwest Region of Cameroon.
BHD is a semi-urban area with diverse socio-economic and cultural characteristics. It serves as a key
administrative and healthcare hub in the region, providing access to several health facilities and services. The
district comprises multiple health areas and communities, which were included in the study through a cluster
sampling approach.
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The focus of the study was on men aged 40–60 years residing in selected communities within BHD. This age
group was chosen due to its higher risk of developing prostate cancer. The study aimed to assess their
knowledge, attitudes, and practices (KAP) regarding prostate cancer screening, as well as the challenges they
face in accessing screening services.
Sampling
In this study, a multi-stage sampling method was used to recruit 314 study participants wherein 4 Health areas
were randomly selected from the 7 health areas of the BHD. Eight communities were further randomly
selected, 2 communities from each of the 4 health areas. A simple random sampling technique was used to
select the households. Finally, study participants were selected using purposive sampling. Calculation of the
sample size used a 5% margin of error with a 95% confidence level. A minimum sample size of 314 was
determined using the Conchran’s formula.
Data Collection: A structured questionnaire was used to collect data for this study. The development of the
questionnaire was guided by past studies on a similar topic carried out by Nawafia et al. in Namibia and Ernest
et al. in Cameroon.
The questionnaires were self-administered and with the help of research assistants among selected households
in the community.
Statistical Analysis
Analysis was done using SPSS version 26.0 where data was exported from excel and later analysed
summarizing results on tables and charts.
Ethical Considerations: Ethical clearance for this study were obtained from the Institutional Review Board,
Faculty of Health Sciences, University of Buea (reference number 2024/2340-01/UB/SG/IRB/FHS).
Authorization was also obtained from the Delegation of Public Health (reference number
P42/MPH/SWR/RDPH/CB.PT/730/636). Authorization was obtained from the District Health Service Buea.
Authorization was also gotten from different chief of centers at selected health areas and verbal authorization
obtained from the chiefs of the selected communities in those health areas. An informed consent was gotten
from the study participants.
RESULTS
Socio-Demographic Characteristics of Participants
Table 1 presents the socio-demographic characteristics of study participants. Out of the 314 participants, 104
(33.1%) of them were from Molyko health area while 68 (21.7%) were from Bokwango health area. Also, 71
(22.6%) were from Ndongo community while 20 (6.4%) were from Likoko membea. Most of the participants
were Christians 273 (86.9%) and 158 (50.3%) belonged to the age group 50-60 years. As per the employment
status, 156 (49.7%) were self-employed while 50 (16%) were unemployed. More so, 101 (32.2%) earned more
than 100000frs monthly while 32 (10.25) earned less than 25000frs monthly. One hundred and seventeen
(37.3%) of the participants had attained the secondary level of education while 9 (2.9%) had no formal
education. Most, 230 (73.2%) of the participants were married while 10 (3.2%) were separated (See Table 1).
Table 1: Socio-demographic Characteristics of Participants
Variables
Categories
Frequency (n)
Percent (%)
Health area
Bokwango
72
22.9
Buea Town
68
21.7
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Molyko
104
33.1
Tole
70
22.3
Total
314
100
Community
Bokwai layout
33
10.5
Bwiyuku
43
13.7
Likoko Membea
20
6.4
Mevio
27
8.6
Naanga
53
16.9
Ndongo
71
22.6
Stranger East
38
12.1
Wonyalyonga
29
9.2
Total
314
100
Religion
Christian
273
86.9
Muslim
22
7.0
Others
19
6.1
Total
314
100
Age group
40-49 years
156
49.7
50-60 years
158
50.3
Total
314
100
Employment status
Employed
110
35.0
Self-employed
154
49.0
Unemployed
50
16.0
Total
314
100
Income per month (x1000 CFA)
<25
32
10.2
25-50
93
29.6
50-100
88
28.0
>100
101
32.2
Total
314
100
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Educational level
No formal education
9
2.9
Primary
82
26.1
Secondary
117
37.3
University
106
33.8
Total
314
100
Marital status
Married
230
73.2
Separated
10
3.2
Single
63
20.1
Widower
11
3.5
Total
314
100
Overall Knowledge on Prostate Cancer
For overall knowledge, 62.74% (197) of the participants had poor knowledge on prostate cancer while 37.26%
(117) of the participants had good knowledge on prostate cancer (See Figure 1).
Figure 1: Overall Knowledge on Prostate Cancer
Tables 2 shows the association between overall knowledge and demographic characteristics. There was a
significant association between knowledge on prostate cancer and health area (χ
2
=33.1, p<0.001), community
(χ
2
=36.75, p<0.001), income per month (χ
2
=9.83, p=0.020), age group (χ
2
=4.41, p<0.036) (See Table 2)
Table 2: Association between overall knowledge and demographic characteristics.
Overall Knowledge
Categories
Poor
Good
Chi-
square
P-value
n (%)
n (%)
Bokwaongo
49(68.1)
23(31.9)
33.1
<0.001
Buea Town
44(64.7)
24(35.3)
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Molyko
31(29.8)
73(70.2)
Tole
40(57.1)
30(42.9)
Total
164(52.2)
150(47.8)
Bokwai layout
11(33.3)
22(66.7)
36.755
<0.001
Bwiyuku
21(48.8)
22(51.2)
Likoko Membea
13(65.0)
7(35.0)
Mevio
19(70.4)
8(29.6)
Naanga
37(69.8)
16(30.2)
Ndongo
20(28.2)
51(71.8)
Stranger East
25(65.8)
13(34.2)
Wonyalyonga
18(62.1)
11(37.9)
Total
164(52.2)
150(47.8)
Christian
142(52.0)
131(48.0)
5.73
0.057
Muslim
8(36.4)
14(63.6)
Others
14(73.7)
5(26.3)
Total
164(52.2)
150(47.8)
Employed
62(56.4)
48(43.6)
4.983
0.083
Self-employed
83(53.9)
71(46.1)
Unemployed
19(38.0)
31(62.0)
Total
164(52.2)
150(47.8)
<25
9(28.1)
23(71.9)
9.826
0.020
>100
56(55.4)
45(44.6)
25-50
55(59.1)
38(40.9)
50-100
44(50.0)
44(50.0)
Total
164(52.2)
150(47.8)
No formal
education
6(66.7)
3(33.3)
3.702
0.295
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Primary
40(48.8)
42(51.2)
Secondary
56(47.9)
61(52.1)
University
62(58.5)
44(41.5)
Total
164(52.2)
150(47.8)
40-49 years
90(58.1)
66(41.9)
4.411
0.036
50-60 years
73(46.2)
85(53.8)
Total
164(52.2)
150(47.8)
Married
119(51.7)
111(48.3)
2.636
0.451
Separated
3(30.0)
7(70.0)
Single
36(57.1)
27(42.9)
Widower
6(54.5)
5(45.5)
Total
164(52.2)
150(47.8)
Table 3 shows the demographic factors independently associated to knowledge. Men who were from Molyko
health area were 0.422 time less likely to have poor knowledge on prostate cancer compared men from Tole
(AOR=0.422, CI=0.79-6.28, P<0.001) (See Table 3)
Table 3: Association between Overall Knowledge and Socio-demographic characteristics of Participants using
Multivariate Analysis
Categories
AOR
CI (95%)
P-value
Health Area
Bokwaongo
1.385
(-0.39,1.64)
0.370
Buea Town
0.777
(-0.97,0.95)
0.488
Molyko
4.637
(0.79,6.28)
<0.001
Tole
1
Income per month (X1000CFA)
<25
2.950
(0.08,3.09)
0.035
25-50
0.553
(-1.25,0.2.33)
0.079
50-100
1.194
(-0.46,3.33)
0.586
>100
1
Attitudes towards Prostate Cancer Screening
Regarding the overall attitude of men towards prostate cancer screening, 50.32% (158) of them had positive
attitude while 49.68% (156) had negative attitudes towards prostate cancer screening (See Figure 2).
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Figure 2: Overall Attitude towards Prostate Cancer Screening
Socio-demographic characteristics were associated with overall attitudes and associations which were
significant were: health area, community, age-group, Income per month, educational status and marital status
(see Table 4).
Table 4: Socio-demographic characteristics associated with overall attitude towards prostate cancer screening
Variable
Categories
Overall attitude
Chi-
square
P-
value
Negative n (%)
Positive n (%)
Health area
Bokwaongo
33(23.9)
39(22.2)
85.97
<0.001
Buea Town
17(12.3)
51(29.0)
Molyko
80(580)
24(13.6)
Tole
8(5.8)
62(35.2)
Total
138(100.0)
176(100.0)
Community
Bokwai layout
24(17.4)
9(5.1)
94.96
<0.001
Bwiyuku
4(2.9)
39(22.2)
Likoko
Membea
7(5.1)
13(7.4)
Mevio
4(2.9)
23(13.1)
Naanga
26(18.8)
27(15.3)
Ndongo
56(40.6)
15(8.5)
Stranger East
4(2.9)
34(19.3)
Wonyalyonga
13(9.4)
16(9.1)
Total
138(100.0)
176(100.0)
Age-group
40-49 years
54(39.1)
101(57.7)
10.66
0.001
50-60 years
84(60.9)
74(42.3)
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Total
138(100.0)
176(100.0)
Employment
status
Employed
54(34.1)
56(31.8)
2.032
0.362
Self-employed
62(44.9)
92(52.3)
Unemployed
22(15.9)
28(15.9)
Total
138(100.0)
176(100.0)
Religion
Christian
121(87.7)
152(86.4)
0.124
0.940
Muslim
9(6.5)
13(7.4)
Others(Pagan)
8(5.8)
11(6.3)
Total
138(100.0)
176(100.0)
Income per
month
<25,000CFA
15(10.9)
17(9.7)
36.276
<0.001
>100,000CFA
62(44.9)
39(22.2)
25,000-
50,000CFA
18(13.0)
75(42.6)
50,000-
100,000CFA
43(31.2)
45(25.6)
Total
138(100.0)
176(100.0)
Educational
level
No formal
education
3(2.2)
6(3.4)
33.79
<0.001
Primary
15(10.9)
67(38.1)
Secondary
69(50.0)
48(27.3)
University
51(37.0)
55(31.3)
Total
138(100.0)
176(100.0)
Marital status
Married
108(78.3)
122(69.3)
17.67
0.001
Separated
7(5.1)
3(1.7)
Single
15(10.9)
48(27.3)
Widower
8(5.8)
3(1.7)
Total
138(100.0)
176(100.0)
Table 5 presents the demographic factors independently associated with attitude towards prostate cancer
screening. Men who lived in Bokwaongo were 4.392 times more likely to have a negative attitude towards
prostate cancer screening compared to those who lived in Tole (AOR=4.392, CI=0.48-8.478, P=0.004) (See
Table 5).
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Table 5: Socio-Demographic factors independently associated with attitude towards prostate cancer
screening.
AOR
CI (95%)
P-value
Health area
Bokwaongo
4.392
(0.48,8.478)
0.004
Buea town
2.148
(-.0224,1.753)
0.129
Molyko
18.556
(6.897,20.944)
<0.001
Tole
1
Income per month(x1000CFA)
<25
0.943
(-1.095,0.977)
0.912
>100
1.629
(-0.210,1.186)
0.171
25-50
0.458
(-1.572,0.671)
0.053
50-100
1
Educational level
No formal education
1.734
(-1.284,2.385)
0.556
Primary
1.281
(-0.689,1.457)
0.604
Secondary
2.807
(0.327,3.865)
0.004
University
1
Age-group
40-49 years
0.467
(-1.335,0.972)
0.009
50-60 years
1
Overall Practices towards Prostate Cancer Screening
As per the overall practice of prostate cancer screening, 96.82% (304) of them had poor practice while 3.18%
(10) had good practice (See Figure 3).
Figure 3: Overall Practice Level
Overall practice level was associated with socio-demographic characteristics and associations that were
significant was: employment status (See Table 6).
Table 6: Association between Socio-demographic characteristics and overall practice of prostate cancer
screening among men aged 40-60 years.
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Overall Practice
Category
Poor n (%)
Good n(%)
Chi-square
P-value
Health area
Bokwaongo
70(23.0)
2(20.0)
3.491
0.322
Buea Town
65(21.4)
3(30.0)
Molyko
103(33.9)
1(10.0)
Tole
66(21.7)
4(40.0)
Total
304(100.0)
10(100.0)
Community
Bokwai layout
32(10.5)
1(10.0)
5.242
0.630
Bwiyuku
41(13.5)
2(20.0)
Likoko Membea
19(6.3)
1(10.0)
Mevio
25(8.2)
2(20.0)
Naanga
52(17.1)
1(10.0)
Ndongo
71(23.4)
0(0.0)
Stranger East
36(11.8)
2(20.0)
Wonyalyonga
28(9.2)
1(10.0)
Total
304(100.0)
10(100.0)
Age-group
40-49 years
149(48.8)
7(70.0)
1.733
0.188
50-60 years
155(51.2)
3(30.0)
Total
304(100.0)
10(100.0)
Employment status
Employed
107(35.2)
3(30.0)
9.384
0.009
Self-employed
152(50.0)
2(20.0)
Unemployed
45(14.8)
5(50.0)
Total
304(100.0)
10(100.0)
Income per month
(x1000CFA)
<25
30((9.9)
2(20.0)
2.564
0.464
>100
98(32.2)
3(30.0)
25-50
89(29.3)
4(40.0)
50-100
87(28.6)
1(10.0)
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Total
304(100.0)
10(100.0)
Educational level
No formal
education
9(3.0)
0(0.0)
7.158
0.067
Primary
82(27.0)
0(0.0)
Secondary
114(37.5)
3(30.0)
University
99(32.6)
7(70.0)
Total
304(100.0)
10(100.0)
Marital status
Married
222(73.0)
8(80.0)
0.755
0.860
Divorced
10(3.3)
0(0.0)
Single
61(20.1)
2(20.0)
Widower
11(3.6)
0(0.0)
Total
304(100.0)
10(100.0)
Association using multiple logistic regression was done between overall practice level and socio-demographic
characteristics. Associations that were significant were: employment status (Self-employed) and age-group
(40-49 years) (See Table 7).
Table 7: Association between overall level of practice and socio-demographic data using Multivariate
Analysis
Category
AOR
CI (95%)
P-value
Employment status
Employed
0.098
(-4.05,-0.60)
0.008
Self-employed
0.046
(-5.00,.0.25)
0.002
Unemployed
1
Age-group
40-49 years
5.828
(0.13,9.39)
0.034
50-60 years
1
Challenges Faced Towards Prostate Cancer Screening
For the challenges faced towards prostate cancer screening, most participants did not have any challenge
towards screening 72.9% (229) and amongst the participants who faced challenges, they identified lack of
finance as their main challenge representing 40.2% (85) of the participants (See Table 8)
Table 8: Challenges faced towards Prostate Cancer Screening
Variable
Response
Frequency
(n)
Percent (%)
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Faced challenges towards Prostate Cancer screening
No
229
72.9
Yes
85
27.1
Total
314
100
Challenges faced towards Prostate cancer screening
Lack of
finance
45
40.2
Lack of time
13
11.6
Laziness
12
10.7
Ignorance
32
28.6
Fear
10
8.9
Total
112
100
DISCUSSION
Knowledge towards prostate cancer screening
In assessing level of knowledge, a greater proportion of the participants could not define prostate cancer.
Above half of the participants could not identify the gender prostate cancer affects. The findings of this study
were different from a study carried out in Namibia which reported that 42.4% of the participants could not
define prostate cancer [7]. The findings of this study were also different from a study carried out in South
Africa, where they reported that 54.4% of their participants could not identify the gender affected by prostate
cancer [8,9].
With all the questions on risk factors, treatment, prevention and symptoms on prostate cancer being asked, the
overall knowledge levels were graded and our findings showed that, Below half of the participants had good
knowledge on prostate cancer. The findings on overall knowledge of the participants was similar to a study
carried out by in Nigeria where they reported that 54.9% of their participants had poor knowledge on prostate
while 45.1% had good knowledge on prostate cancer [9].
The findings were also similar to a study carried out in Tanzania where they reported 52% of their respondents
to have poor knowledge on prostate cancer while 48% of their respondents had good knowledge on prostate
cancer [10].The similarities in the studies may be due to the fact that all the studies carried out were in low
income African countries with similar characteristics to the participants in our study.
Men in the Molyko community were more likely to have poor knowledge on Prostate cancer compared to
those in the Tole community.
Also, men who earned less than 25,000CFA were more likely to have poor knowledge on prostate cancer
compared to those who earned more than 100,00CFA
Attitudes towards prostate cancer screening
Understanding men’s attitudes towards prostate cancer screening is necessary for informing effective public
health information and promoting informed decision making. Our findings on attitudes towards prostate cancer
screening showed that most participants do not consider screening for prostate cancer. Our findings are in
contrast with a study carried out in Nigeria which showed that 96.1% of the participants were willing to screen
for prostate cancer [8].
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Also, 35.7% of participants from this study disagreed to the fact that screening was not necessary if one was fit
and healthy which was different from a study carried in South Africa which reported that, 67.8% of their
participants disagreed to the fact that, screening was necessary if one was fit and healthy [1].
Furthermore, 20.4% of the study participants had never considered screening for prostate cancer which was
different from a study carried out in South Africa which reported that 60.8% of their participants had
considered screening for prostate cancer [1,10]. A greater proportion of the participants agreed to the fact that
all adults should undergo a prostate cancer screening test which was different from a study carried out in
Nigeria which showed that, 39.2% of their participants agreed that it was necessary to screen for prostate
cancer as an adult [5,11].
Overall attitude levels were obtained after grading the individual questions and it showed that 56.05% of our
participants had positive attitudes towards prostate cancer screening and 43.95% had negative attitudes
towards prostate cancer screening.
Our findings were different from a study carried out in Nigeria where 65.7% of participants expressed positive
attitudes towards prostate cancer screening while 34.3% of the participants expressed negative attitudes
towards prostate cancer screening [1,12]. Also, the findings were different from a study carried out in South
Africa where 84.9% of the participants expressed positive attitudes towards prostate cancer screening while
15.1% expressed negative attitudes towards the screening for prostate cancer [1].
The difference in attitude levels may be due to differences in cultural beliefs and religious factors which play a
significant role in shaping attitudes towards prostate cancer screening.
Overall attitude levels were associated with socio-demographic characteristics, whether they had heard of
prostate cancer before and whether they had heard of prostate cancer screening before. Significant associations
were found with: health area (Bokwango and Molyko), Income level (25,000-50,000 CFA), whether they had
heard of prostate cancer before and whether they had heard of prostate cancer screening before with p-values
<0.05 and confidence intervals excluding zero. The findings were different from a study carried out in Italy
which showed that attitudes towards prostate cancer screening were influenced by fear, discomfort and trust in
healthcare providers [13].
Practices Towards Prostate Cancer Screening.
Our findings revealed 91.7% of the participants had not screened for prostate cancer before while 8.3% had
screened for prostate cancer before which was similar to a study carried out in Cameroon which reported that
8.1% of their participants had screened for prostate cancer before [6].
Most (95.9%) of the participants had never undergone a Prostate Specific Antigen test before and most
(97.8%) of them had never undergone a digital rectal examination. Our findings were similar to a study carried
out in Tanzania which showed that 92.3% of participants had never undergone a PSA test and a DRE. The
findings may be similar due to similarity in study participants like the age and race [10].
Also, our findings revealed only 4.1% of the participants had undergone a PSA test before which was different
from a study carried out in Italy where they reported that 29.6% of men had undergone a PSA test before and
similar to a study carried out by Bugoye et al. (2019) which reported that, 7.7% of the participants had
undergone a PSA test. This difference may be due to the different strategies put in place to enhance screening
practices in the different countries [12].
Overall practice level from our study showed that 3.18% of the participants had good practices towards
prostate cancer screening while 96.82% of the participants had bad practices towards prostate cancer screening
from their screening rates. These findings were similar to a study carried out in Namibia where it showed that
4.7% of the participants had good practices towards prostate screening [7].
Multiple logistic regression indicated that employment status, age-group and whether they had heard of
prostate cancer screening before were significantly associated with overall screening levels with p-values
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<0.05 and confidence intervals excluding zero. These findings were different from a study carried out in
France that showed that healthcare provider recommendations and accessibility to screening services
influenced screening practices [14].
Challenges faced towards prostate cancer screening
Challenges most often are being faced which may limit certain practices. Our study brought out some of the
challenges the participants faced towards screening for prostate cancer which may have limited their practice.
Most of our participants did not face challenges towards prostate cancer screening while 27.1% of the
participants faced challenges towards prostate cancer screening. These results may be due to the fact that most
participants did not see a need for screening and so, they could not determine whether they had a challenge or
not.
Out of the challenges specified by most participants, lack of finance was the highest challenge faced with
40.2% followed by, ignorance with 28.6% then laziness with 11.6%. Lack of finance is mostly common
among individuals in low income countries. Also, ignorance on prostate cancer screening was seen as a
challenge because most of the individuals had never been informed about screening techniques and so, had
limited information about the screening procedure. These challenges being specified are most often common
amongst low income countries
CONCLUSIONS
Prostate cancer is a significant Public Health issue in Cameroon but we find most men neglecting it and paying
attention to it only when it has started presenting with signs and symptoms which may be at a terminal stage.
From this study, conclusions made were:
Majority of our study participants had poor knowledge on prostate cancer despite the fact that most of them
had heard of prostate cancer before and majority had not heard of its screening before. The poor knowledge
made them inquire more about it after answering the questionnaires.
A greater proportion of the participants had positive attitudes towards prostate cancer screening which made
them have a positive approach towards screening for prostate cancer.
Most of the participants had poor practices towards prostate cancer screening which makes them more
exposed to it if interventions are not put in place to enhance practice levels.
Almost all the participants did not face challenges towards prostate cancer screening which was not expected
due to their low level of practice towards screening for prostate cancer. Notwithstanding, specific challenges
being faced by some participants were brought out and strategies can be put in place based on those
challenges.
Finally, with prostate cancer being one of the leading causes of death amongst men and of Public health
concern, we still find most men avoiding screening for it.
CONFLICT OF INTERESTS
The authors have not declared any conflict of interests.
ACKNOWLEDGEMENTS
The authors are grateful to all participants who took part in this study, and their sincere gratitude goes to the
data collectors.
Clinical trial number: not applicable.
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Funding: No external funding was used for this work
Human Ethics and Consent to Participate declarations: This study was conducted in compliance with the
Helsinki Declaration and all applicable national laws and institutional rules and has been approved by the
author’s institutional review board. Ethical approval was granted by the institutional review board Faculty of
health sciences, University of Buea Application No: 2340-01. Informed consent was obtained from all subjects
involved in the study.
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