24 UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE The profile of Black South African men diagnosed with prostate cancer in the Free State, South Africa Authors: 1 Matthew O.A. Benedict 1 Wilhelm J. Steinberg Frederik 2 M. Claassen Nathaniel 3 Mofolo Afliations: 1Department of Family Medicine, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein, South Africa 2Department of Urology, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein, South Africa 3Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein, South Africa Corresponding author: Matthew Benedict, benedictMA@ufs.ac.za First Published in South African Family Practice. 65(1). 10 Jan 2023. Republished with permission. Benedict MOA, Steinberg WJ, Claassen FM, Mofolo N. The prole of Black South African men diagnosed with prostate cancer in the Free State, South Africa. S Afr Fam Pract. 2023;65(1), a5553. https://doi.org/10.4102/safp. v65i1.5553 Copyright: © 2023. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License. Background: Prostate cancer (PCa) ranks high in terms of morbidity and mortality, especially in Africa. Prostate-specic antigen (PSA) screening remains a practical method of screening for and thereby detecting PCa early, especially among African men who are more negatively affected. Modiable risk factors for PCa are mostly behavioural and lifestyle. Understanding community- specic determinants is important when developing health promotion interventions. Objective: This study aimed to determine the prole of African men with PCa in the Free State, South Africa. Method: A cross-sectional descriptive study was conducted using case record information and self-administered questionnaires among 341 African men with PCa attending the oncology and urology clinics of a tertiary hospital. Result: Participants' median age at diagnosis was 66 years. Only 76 (22.3%) participants had ever heard of PCa prior to being diagnosed with the disease, 36 (47.4%) of whom had ever had screening performed. The majority (n = 298, 87.4%) were symptomatic; < 50% sought medical help within six months. At diagnosis, 133 (39.0%) men presented with stage T3 or T4 disease, 75 (22.0%) with metastatic disease and 84 (24.6%) with Gleason score ≥ 8. Factors associated with advanced and high-grade disease included smoking, decreased sunlight exposure and physical activity, relatively increased ingestion of dairy products and red meat. Factors associated with early stage and low-grade disease included relatively increased ingestion of fruits, vegetables and sh. Conclusion: Advanced and high-grade PCa disease is not uncommon among men ≥ 60 years in this study setting. Certain modiable risk factors associated with advanced disease were established in this study. The majority had lower urinary tract symptoms (LUTS) prior to PCa diagnosis, but they were of poor healthseeking behaviour. Although there seems not to be a systematic delay in the denitive diagnosis and initiation of treatment for PCa, there is a need to improve on health education and awareness in the study setting. Keywords: prostate cancer; Black men; African men; risk factors; social determinants; disease stage and grade.
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