Prostate Cancer Awareness, Knowledge, Perception on Self-vulnerability and Uptake of Screening among Men in Nairobi County, Kenya
Prostate cancer is the number one cancer afflicting men in Africa and a leading cancer killer among Kenyan men. Although there is scarcity of information on the disease in African men, higher awareness with concomitant low levels on knowledge, attitudes and perception of self-risk to the disease were established among urban men in West Africa. In addition, uptake of prostate cancer screening by African men has remained extremely low despite the fact that early screening and detection is the most effective intervention tool for the disease. A lack of awareness and knowledge and poor perception on prostate cancer and prostate cancer screening, and a low uptake of screening appear to promote the increasing burden of the cancer. Most of the reports on prostate cancer from Kenya have largely been hospital-based hence little is known about prostate cancer in the community. Although prostate cancer is the leading cancer in Nairobi, awareness, knowledge and perceptions of the cancer including uptake of screening remains undetermined among men from the Nairobi community. As such, this house-hold cross-sectional descriptive study was conducted among men (n=581) of age 30-73 years to evaluate the awareness and knowledge levels; perception of prostate cancer self-vulnerability and uptake of prostate cancer screening in Nairobi County. Data was collected using structured questionnaires and summarised using descriptive statistics and presented in tables and graphs. Statistical analyses for associations between knowledge levels, perception of self-vulnerability to prostate cancer, uptake of prostate cancer screening and socio-demographic characteristics were performed using the chi-square tests followed by Spearman’s correlation tests and binary logistic regression modeling. Results of this study show high prostate cancer awareness (84.6%). The frequency of respondents with good knowledge on prostate cancer was low at 52.3%. The frequency of good perception on self-vulnerability to prostate cancer was 58.0%. Respondents with poor knowledge on prostate cancer were older relative to those with good knowledge (P=0.001) and the knowledge levels on prostate cancer were positively correlated with perception of prostate cancer self-vulnerability (r=0.144; P=0.001). Binary logistic regression analyses revealed that good knowledge of prostate cancer was associated with university [OR, 18.741; 95% CI, 6.878-51.064; P<0.0001]; diploma [OR, 9.332; 95% CI, 3.752-23.213; P<0.0001]; and secondary education [OR, 4.078; 95% CI, 1.650-10.075; P=0.002]. Similarly, good perception of self-vulnerability to prostate cancer was associated with university [OR, 2.405; 95% CI, 1.121-5.162; P=0.024]; diploma [OR, 3.394; 95% CI, 1.699-6.780; P=0.001]; and secondary [OR, 1.832; 95% CI, 0.932-3.603; P=0.079] education. Only 4.1% of the respondents had ever been screened for prostate cancer. Consistent with the low uptake of prostate cancer screening, only 48.2% of the respondents were aware of prostate cancer screening; 7.1% of the respondents knew about the methods of prostate cancer screening; and 45.8% of the respondents knew about the frequency of prostate cancer screening. Moreover, proportions of respondents with good perception about self-vulnerability to prostate cancer were higher than those reporting ever being tested (79.2%) against those that had never been tested (57.1%) for prostate cancer (P=0.032). Of importance, 91.4% of the respondents were willing to take up prostate cancer screening and 97.2% of the respondents were willing to know more about prostate cancer screening. The results of this study demonstrate higher awareness but low knowledge levels on prostate cancer that are accompanied by low perceptions on self-vulnerability to the cancer, low uptake of prostate cancer screening that parallel poor knowledge and perceptions on prostate cancer self-vulnerability and uptake of screening. Thus, public health health intervention targeting information dissemination on prostate cancer; behavioural change on risk perceptions; and uptake of early screening of prostate cancer can halt the increasing burden of the disease.