Advancement of Prostate Cancer Diagnosis in Nigeria: Challenges and the Way Forward

Abstract

Prostate cancer is a major public health problem in men in Nigeria and remains an important cause of cancer-related morbidity and mortality. Early and precise diagnosis is important to improve treatment outcomes, reduce complications and increase survival rates. Recent advances in the diagnosis of prostate cancer include improvements in prostate-specific antigen (PSA) testing, digital rectal examination (DRE), multiparametric magnetic resonance imaging (mpMRI), prostate biopsy techniques, histopathological assessment and molecular diagnostic approaches. However, the adoption and efficient use of these technologies in Nigeria is still hampered by the lack of diagnostic infrastructure, high out-of-pocket expenditure on healthcare, the paucity of skilled specialists, inadequate public knowledge and unequal access to healthcare services. Late presentation, social hurdles and the lack of unified national diagnostic paths add to the complexity in the management of the disease. This article analyses recent developments in prostate cancer diagnosis in Nigeria, addresses problems impacting their implementation and proffers practical recommendations for strengthening diagnostic competence. The way forward proposed includes strengthening primary health care services, expanding access to affordable PSA testing and appropriate imaging, upgrading pathology and laboratory services, training health care professionals, promoting public education, and setting up comprehensive cancer registries. A coordinated effort involving government, healthcare institutions, professional associations, researchers and development partners will be required to improve early detection of prostate cancer and provide equal access to a credible prostate cancer diagnosis in Nigeria.