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Impact of Prostate Cancer Screening Outreach 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 may contribute to substantial morbidity and mortality when detected at advanced stages. The burden of prostate cancer is particularly relevant to men in Nigeria, where awareness of prostate health, access to screening services, and utilization of preventive healthcare may vary across communities. Men may face barriers to prostate cancer screening, including limited knowledge, financial constraints, fear of diagnostic procedures, concerns about stigma, geographical inaccessibility, and misconceptions about screening. Prostate cancer screening outreach provides an opportunity to bring information, risk assessment, screening services, and referral pathways closer to men who may otherwise have limited access to preventive healthcare. Against this background, this study investigates the impact of prostate cancer screening outreach on prostate cancer screening uptake among men aged 40 years and above in Nigeria. The study will be anchored on the Health Belief Model, Andersen's Behavioral Model of Health Services Use, and the Social Ecological Model. The Health Belief Model explains how men's perceptions of their susceptibility to prostate cancer, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence screening uptake. Andersen's Behavioral Model explains healthcare utilization through predisposing characteristics, enabling resources, and perceived or evaluated need for healthcare. The Social Ecological Model emphasizes the influence of individual, interpersonal, community, healthcare-system, and broader environmental factors on preventive health service utilization. Collectively, these theoretical perspectives provide a suitable framework for explaining how prostate cancer screening outreach may influence screening uptake among men aged 40 years and above in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise men aged 40 years and above residing in selected urban, semi-urban, and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, and eligible participants. Prostate cancer screening outreach will be assessed using indicators such as frequency and coverage of outreach activities, prostate cancer education, availability of screening services, accessibility of screening locations, availability of trained healthcare personnel, risk assessment, counselling, information about screening options, screening invitations, affordability, referral arrangements, and follow-up services. Prostate cancer screening uptake will be assessed using indicators such as participation in screening during the study period, completion of recommended screening procedures, attendance at screening appointments, repeat screening where clinically appropriate, acceptance of screening after counselling, and completion of referrals for further evaluation when indicated. Because prostate cancer screening decisions require individualized clinical assessment, the study will distinguish screening participation from diagnostic confirmation and will document the specific screening approach used in the study setting. Data will be collected using structured questionnaires, validated men's health and cancer-screening instruments, outreach attendance registers, screening records, referral registers, and relevant programme documents, subject to appropriate ethical and confidentiality safeguards. Descriptive statistics will be used to summarize participants' characteristics, exposure to outreach activities, and screening uptake. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of prostate cancer screening outreach on screening uptake. Where a quasi-experimental design is adopted, screening uptake before and after implementation of the outreach programme may be compared with that of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that prostate cancer screening outreach has a significant positive impact on screening uptake among men aged 40 years and above in Nigeria. Men exposed to accessible and well-organized outreach activities are expected to demonstrate greater awareness of prostate cancer and increased participation in appropriate screening services than men without access to such programmes. Community-based education, individualized counselling, convenient screening locations, and clear information about the potential benefits and limitations of screening may reduce informational and geographical barriers to preventive healthcare. Outreach activities may also provide opportunities for healthcare workers to identify men requiring further clinical evaluation and facilitate appropriate referral. However, financial constraints, fear of cancer diagnosis, misconceptions about prostate cancer, concerns about screening procedures, stigma, limited availability of trained personnel, and weak referral and follow-up systems may reduce screening uptake. The study therefore expects accessible, culturally appropriate, confidential, and well-organized prostate cancer screening outreach programmes to contribute significantly to improved uptake of appropriate prostate cancer screening among older adult men in Nigeria. The study is expected to contribute to the literature on prostate cancer screening outreach, prostate cancer screening uptake, men's health, cancer prevention, preventive healthcare, health-seeking behaviour, community health, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare facilities, hospitals, urology and oncology services, community health workers, men's health organizations, development partners, and policymakers regarding strategies for improving prostate cancer prevention and early detection. The study will also provide evidence-based recommendations for expanding community-based prostate cancer education and screening services, reducing financial and geographical barriers, improving access to trained healthcare personnel, strengthening counselling and referral systems, promoting informed screening decisions, and developing sustainable men's cancer prevention programmes across Nigeria.

Keywords: Prostate cancer screening outreach, prostate cancer screening uptake, men aged 40 years and above, prostate cancer, men's health, cancer screening, preventive healthcare, early detection, health-seeking behaviour, Nigeria, public health.