Abstract

Prostate cancer is an important public health concern among men and contributes substantially to cancer-related morbidity and mortality, particularly when diagnosis occurs at an advanced stage. Early detection through appropriate screening and timely clinical evaluation may improve opportunities for diagnosis and management. Prostate cancer awareness involves knowledge of the disease, risk factors, possible symptoms, family history, age-related risk, available screening approaches, potential benefits and limitations of screening, and the importance of seeking professional medical advice. Prostate cancer screening practices refer to men's utilization of appropriate screening or risk-assessment services, consultation with healthcare professionals regarding screening, participation in recommended screening when indicated, and follow-up of abnormal findings. In Nigeria, inadequate awareness, misconceptions about prostate cancer, fear of a cancer diagnosis, concerns about screening procedures, financial constraints, limited access to healthcare facilities, and insufficient health education may discourage men from seeking screening services. Improving prostate cancer awareness may increase men's understanding of their risk and the importance of early detection and encourage appropriate screening practices. Against this background, this study investigates the influence of prostate cancer awareness on prostate cancer screening practices among men aged 40 years and above in Nigeria. The study is anchored on the Health Belief Model (HBM), Theory of Planned Behavior (TPB), and Knowledge-Attitude-Practice (KAP) 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. The Theory of Planned Behavior proposes that attitudes, subjective norms, and perceived behavioural control influence intentions and subsequent health behaviours, including cancer screening. The Knowledge-Attitude-Practice framework provides a basis for examining how increased awareness and favourable attitudes toward early detection may influence screening practices. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how prostate cancer awareness may influence screening practices among men aged 40 years and above in Nigeria. The study adopts a quantitative cross-sectional 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. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible participants. Prostate cancer awareness will be measured using participants' knowledge of prostate cancer risk factors, family history, symptoms, prevention, early detection, available screening approaches, and appropriate healthcare-seeking practices. Prostate cancer screening practices will be assessed based on participants' history of consultation regarding prostate cancer screening, previous screening or risk assessment where applicable, timing of the most recent screening, willingness to undergo appropriate screening after professional counselling, and follow-up of previous screening results. Where feasible and ethically appropriate, self-reported screening information may be supported by available healthcare records. Descriptive statistics will be used to summarize participants' sociodemographic and health characteristics, levels of prostate cancer awareness, and screening practices. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple logistic regression analysis, will be employed to determine the influence of prostate cancer awareness on screening practices. Appropriate diagnostic tests will also be conducted to assess multicollinearity, model specification, goodness of fit, and the robustness of the findings. The study anticipates that higher levels of prostate cancer awareness will have a significant positive influence on prostate cancer screening practices among men aged 40 years and above in Nigeria. Men with greater awareness are expected to demonstrate better knowledge of prostate cancer risk factors, symptoms, family history, and available screening approaches and to be more likely to discuss screening with qualified healthcare professionals. Increased awareness may improve perceived susceptibility, reduce misconceptions and fear, encourage early healthcare seeking, and increase participation in appropriate screening or risk-assessment services following informed clinical advice. However, awareness alone may not guarantee screening uptake because men may continue to face barriers such as cost, limited access to healthcare facilities, concerns about screening procedures, fear of diagnosis, cultural perceptions of masculinity, privacy concerns, and inadequate availability of cancer screening services. Consequently, prostate cancer awareness programmes are expected to be most effective when combined with accessible, affordable, confidential, evidence-based, and appropriately delivered screening and clinical evaluation services. This study is expected to contribute to the literature on prostate cancer prevention, cancer screening, men's health, health education, health-seeking behaviour, and public health in Nigeria by providing empirical evidence on the relationship between prostate cancer awareness and screening practices among men aged 40 years and above. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, state ministries of health, hospitals, primary healthcare facilities, cancer-control programmes, urologists, medical practitioners, public health 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 prostate cancer education, promoting informed discussions between men and healthcare professionals, improving access to appropriate screening and risk-assessment services, addressing misconceptions and stigma, strengthening referral and follow-up systems, and integrating men's cancer education into routine healthcare services across Nigeria.

Keywords: Prostate cancer awareness, prostate cancer screening, screening practices, men aged 40 years and above, prostate cancer prevention, early detection, men's health, health education, cancer screening, health-seeking behaviour, public health, Nigeria.