30 The majority (91.2%) of the participants had less than Grade 12 as their highest level of education. This may also explain why the majority (89.5%) were working in either unskilled or semiskilled jobs such as farming and agricultural work, mining, casual labour and other informal jobs. Clinical features among the participants The majority (87.4%) of men in this study had LUTS prior to the diagnosis of PCa. It may therefore be useful for family physicians and GPs to consider symptomatic 15 men for screening as recommended by SAPCDTG. Literature has described similar symptoms among patients, with 47% being asymptomatic. Bone ache and weight loss have been described as symptoms 39 suggestive of metastatic diseases. Our study shows that about a quarter of the participants presented with lower back pain. About 25% of the participants presented with impotence. This may however be because of androgen deciency and certain cardiovascular diseases, which are not uncommon among the middle-aged and elderly. The top comorbid conditions among participants in this study were hypertension and diabetes mellitus. Although the majority (77.2%) of the symptomatic men in this study sought medical attention out of selfconviction; the rest required some persuasion from family and healthcare providers. This may explain why more than 50% of the symptomatic men only sought medical attention after six months. According to Shaw 40 et al., involvement of family members in shared decision-making for PCa screening and treatment is often benecial. In another study, the other reasons for delayed presentation include nancial barriers, lack of health insurance and poor health-seeking behaviour. UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE
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