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Impact of Prostate Cancer Awareness 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 and contributes substantially to cancer-related morbidity and mortality. Early detection through appropriate risk assessment, informed screening decisions, and timely medical evaluation can improve opportunities for diagnosis and treatment. Men aged 40 years and above represent an important population for prostate cancer awareness and screening discussions because prostate cancer risk generally increases with age, while family history and other factors may further influence individual risk. Prostate cancer awareness provides men with information about prostate cancer, risk factors, symptoms, family history, available screening options, potential benefits and limitations of screening, and the importance of discussing screening with qualified healthcare professionals. Prostate cancer screening uptake refers to the utilization of appropriate prostate cancer screening or risk-assessment services following informed discussion with healthcare professionals, where screening is clinically appropriate. In Nigeria, inadequate awareness, misconceptions about prostate cancer, fear of diagnosis, concerns about screening procedures, financial constraints, stigma, limited access to healthcare services, and inadequate knowledge of available screening options may contribute to low screening uptake. Effective prostate cancer awareness may improve men's knowledge, risk perception, and willingness to discuss and utilize appropriate screening services. Against this background, this study investigates the impact of prostate cancer awareness 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 Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding men's decisions regarding prostate cancer screening. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping health behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from prostate cancer awareness may influence screening uptake. Collectively, these theoretical perspectives provide a suitable framework for explaining how prostate cancer awareness may influence prostate cancer 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 and healthcare facilities in Nigeria using a structured interviewer-administered questionnaire and, where feasible, verification of screening attendance through appropriate healthcare records with participants' consent and confidentiality safeguards. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible men. Where feasible, selected communities or participant groups will be assigned to intervention and comparison groups. Participants in the intervention group will receive structured prostate cancer awareness education covering prostate cancer, age-related risk, family history, signs and symptoms, available screening and risk-assessment options, potential benefits and limitations of screening, the importance of shared decision-making with healthcare professionals, and appropriate healthcare-seeking pathways. Prostate cancer screening uptake will be assessed using indicators such as previous screening or risk assessment, attendance for recommended screening services, willingness to undergo appropriate screening following professional counselling, and completion of scheduled screening-related appointments where applicable. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, prostate cancer knowledge, exposure to awareness education, and screening uptake. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the impact of prostate cancer awareness on screening uptake. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that prostate cancer awareness has a significant positive impact on prostate cancer screening uptake among men aged 40 years and above in Nigeria. Men exposed to structured prostate cancer awareness education are expected to demonstrate improved knowledge of prostate cancer risk factors, symptoms, screening options, and the importance of professional risk assessment. Education may increase perceived susceptibility and severity, reduce misconceptions and fear, improve awareness of available screening services, and encourage men to discuss screening with qualified healthcare professionals. However, awareness alone may not guarantee screening uptake because men may continue to face barriers such as cost, limited availability of screening services, geographical distance, fear of diagnosis, concerns about screening procedures, stigma, and inadequate access to appropriate medical counselling. Consequently, prostate cancer awareness is expected to be most effective when supported by accessible healthcare services, affordable screening or risk-assessment options, appropriate counselling, trained healthcare professionals, and community-based cancer prevention programmes. The study is expected to contribute to the literature on prostate cancer prevention, cancer awareness, screening behaviour, men's health, health education, non-communicable disease prevention, and public health in Nigeria by providing empirical evidence on the impact of prostate cancer awareness on prostate cancer screening uptake among men aged 40 years and above. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), National Cancer Control Programme, state ministries of health, local government health authorities, healthcare facilities, urologists, oncologists, primary healthcare professionals, community health workers, development partners, and policymakers regarding strategies for improving prostate cancer prevention and early detection. The study will also provide evidence-based recommendations for strengthening community-based prostate cancer education, improving men's access to reliable screening information, expanding appropriate screening and counselling services, addressing misconceptions and stigma, and promoting informed prostate cancer screening decisions among men aged 40 years and above across Nigeria.

Keywords: Prostate cancer awareness, prostate cancer screening uptake, men aged 40 years and above, prostate cancer, cancer screening, men's health, cancer prevention, health education, early detection, non-communicable diseases, public health, Nigeria.