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Effect of Prostate Cancer Education on Prostate Cancer Screening Uptake among Men Aged 40 Years and Above in Nigeria

Abstract

Prostate cancer is an important public health concern among men, particularly with increasing age. Early detection may facilitate timely clinical assessment and management, while delayed presentation may contribute to diagnosis at more advanced stages and poorer health outcomes. Prostate cancer screening and risk assessment provide opportunities for men to discuss their individual risk and appropriate screening options with qualified healthcare professionals. Prostate cancer education provides men with information about prostate cancer risk factors, age-related risk, family history, symptoms and warning signs, available screening and diagnostic approaches, potential benefits and limitations of screening, appropriate healthcare-seeking, and the importance of discussing screening decisions with qualified healthcare providers. Prostate cancer screening uptake refers to the utilization of appropriate prostate cancer screening or screening-related assessment services by eligible men within the recommended or agreed period. In Nigeria, low utilization of prostate cancer screening may be associated with inadequate knowledge, misconceptions about prostate cancer, fear of diagnosis, concerns about screening procedures, embarrassment, limited awareness of available services, financial barriers, geographical barriers, and inadequate access to men's health services. Effective prostate cancer education may improve men's knowledge, awareness of risk factors, understanding of available screening options, and willingness to seek appropriate professional assessment. Against this background, this study investigates the effect of prostate cancer education on prostate cancer screening uptake among men aged 40 years and above in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and the Knowledge-Attitude-Practice framework. The Health Belief Model provides a framework for understanding men's screening-related decisions through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, and environmental conditions in shaping preventive health behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how prostate cancer education may improve knowledge and attitudes and influence screening-related health behaviour. Collectively, these theoretical perspectives provide a suitable framework for explaining how prostate cancer education may influence screening uptake among men aged 40 years and above in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from men aged 40 years and above in selected communities, public and private healthcare facilities, and men's health programmes in Nigeria using a structured interviewer-administered questionnaire and prostate cancer screening uptake assessment. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible men. Where feasible, selected communities, healthcare facilities, or participant groups will be assigned to intervention and comparison groups. Men in the intervention group will receive structured prostate cancer education covering prostate cancer risk factors, age-related risk, family history, symptoms and warning signs, available screening and diagnostic approaches, potential benefits and limitations of screening, appropriate healthcare-seeking, and the importance of discussing screening decisions with qualified healthcare professionals. Prostate cancer screening uptake will be assessed using indicators such as previous screening history, recent screening-related assessment, utilization of available screening services, and completion of appropriate screening following the educational intervention. Because screening recommendations can depend on age, risk profile, and clinical guidance, the study will distinguish between screening-related awareness and actual utilization of services and will encourage participants to make screening decisions in consultation with qualified healthcare professionals. Where feasible, self-reported screening uptake will be verified through available healthcare records or facility documentation. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, family history, previous prostate cancer education, knowledge, screening history, and screening uptake. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic regression analysis, will be used to determine the effect of prostate cancer education on screening uptake. Where appropriate, screening uptake before and after the intervention will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that prostate cancer education has a significant positive effect on prostate cancer screening uptake among men aged 40 years and above in Nigeria. Men exposed to structured prostate cancer education are expected to demonstrate improved knowledge of prostate cancer risk factors, age-related risk, family history, symptoms, available screening approaches, and the importance of timely professional assessment. Education may increase men's awareness of where appropriate screening-related services are available and encourage informed discussions with healthcare professionals. Addressing misconceptions, fear, embarrassment, and concerns about screening may further improve men's willingness to seek appropriate assessment. However, education alone may not guarantee screening uptake because men may continue to experience barriers such as cost, distance to healthcare facilities, limited availability of screening services, concerns about privacy, fear of diagnosis, inadequate access to men's health services, and limited follow-up capacity. Consequently, prostate cancer education is expected to be most effective when supported by accessible and affordable men's health services, trained healthcare professionals, appropriate counselling, clear referral pathways, and effective follow-up systems. The study is expected to contribute to the literature on prostate cancer prevention, cancer screening, men's health, health education, early cancer detection, preventive healthcare, and public health in Nigeria by providing empirical evidence on the effect of prostate cancer education on screening uptake among men aged 40 years and above. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, National Primary Health Care Development Agency, hospitals, primary healthcare centres, men's health programmes, cancer-control programmes, healthcare professionals, community health organizations, development partners, and policymakers regarding strategies for improving men's awareness and utilization of appropriate prostate cancer screening-related services. The study will also provide evidence-based recommendations for strengthening community-based prostate cancer education, integrating men's cancer education into primary healthcare and health-promotion programmes, improving access to appropriate screening-related services, addressing misconceptions and stigma, strengthening healthcare-provider counselling, and improving referral and follow-up systems for men requiring further clinical assessment.

Keywords: Prostate cancer education, prostate cancer screening uptake, men aged 40 years and above, Nigeria, prostate cancer prevention, men's health, cancer screening, health education, early detection, preventive healthcare, cancer awareness, healthcare utilization, public health, Nigeria.