Abstract
Despite the global increase in awareness of prostatic diseases resulting from widespread availability of screening tools, there is no evidence that the knowledge, attitudes and screening practices of Nigerian men have improved regarding prostatic diseases. A descriptive survey research design amongst 300 community-dwelling men. Respondents were selected using multi-staged sampling techniques. Knowledge, attitudes and screening practices were determined based on responses to a semi-structured questionnaire. Data were analyzed using SPSS version 21. Pearson's chi-square and percentage and graphical method was adopted. The study concludes that there is a poor level of knowledge, attitudes and screening practices regarding prostatic diseases in Nigeria. We recommend a widespread public health education to improve knowledge, attitudes and screening practices for prostatic diseases
CHAPTER ONE
INTRODUCTION
- Background of the study
Prostate cancer is thus an important health burden among men across the globe, the highest incidence rates are found in sub-Saharan Africa (A. Jemal, F. Bray, D. Forman et al. 2012). A systematic review of prostate cancer in Africa estimated an overall continent-wide pooled incidence rate of 21.95/100,000 population. Nigerian Cancer Registry indicates that prostate cancer is the most common cancer among men in Jos (followed by Karposi’s sarcoma) with an incidence of 3,434 cases per year in 2012 (WHO 2014). While screening for prostate cancer using the prostate-specific antigen blood test (PSA) and digital rectal examination (DRE) are effective available measures for early detection of disease, utilization of these services ranges from 0% to 15% in Nigeria. With the “graying” of the “baby boomers”, awareness of prostatic diseases has increased dramatically (Brawer MK, 2012). In particular, prostate cancer (PCa), which is now the most common male malignancy and other prostatic diseases such as benign prostatic hyperplasia (BPH) and prostatitis, are widely discussed in the media and are the subject of increasing interest from family physicians and the general public alike. Prostate cancer is a significant healthcare problem due to its high incidence and mortality and the cost associated with its detection and treatment (Greenlee RT, Murray T 2010). The awareness of prostatic diseases has increased in recent times with the recognition of early detection of PCa as a key factor in reducing mortality and morbidity. It is however sad that majority of patients in our sub-region present with locally advanced and metastatic diseases. Several reasons have been suggested for this trend including a low level of awareness and knowledge, erroneous beliefs about prostatic diseases and poor healthcare-seeking behaviour of patients amongst other factors related to available facilities and poverty. Even though prostatic diseases have received much media attention, studies of the public's knowledge, perceptions or screening practices are not many in Nigeria especially in the rural communities where more than half of Nigerians live (World Bank 2016). Recently, there has been growing interest in the role of knowledge, attitudes and screening practices in PCa prevention and control. A good knowledge or understanding of diseases is generally associated with a better healthcare-seeking attitude and behaviour (Kanungo S, Bhowmik K, 2015). Therefore, efforts at improving awareness about diseases should not be directed at malignant diseases only as efforts towards benign conditions which are by far commoner than malignant ones will also reduce morbidity and mortality significantly. Despite the global increase in awareness as a result of widespread availability of screening tools for prostate diseases, there is no evidence that the knowledge, attitudes and screening practices of Nigerian men have changed regarding prostatic diseases. The aim of the study therefore, is to determine the level of awareness, knowledge and attitudes towards treatment for prostatic diseases as well as screening practices amongst community-dwelling men.
- STATEMENT OF THE PROBLEM
Although, the burden of prostate cancer is high worldwide as it constitutes the second most common cancer among men, its burden is disproportionately higher in Sub-Saharan Africa, Latin America and the Caribbean where it constitutes the most common cancer among men.( Baade PD and Krnjacki LJ 2019). A systematic review of estimates of the incidence of cancer among men in Africa reported median prostate cancer incidence rates ranging from 19.5 to 39.0 per 100,000 population. (Adeloye D, 2016) In Nigeria, similar to the situation in other countries in sub-Saharan Africa, prostate cancer is the most common cancer in men, with evidence of increasing morbidity and mortality from the disease. Studies conducted in North-Western Nigeria also reported high burden of prostate cancer. Whereas, a descriptive retrospective study of all pathologically diagnosed cancers in the records of the Histopathology Department of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, between January 1999 and December 2004 reported prostate cancer as the second most common cancer in men (9.9%) after bladder cancer (15.7%),( Malami SA, 2017) a 10- year analysis of the Kano Cancer Registry (1995-2004) reported prostate cancer as the most common cancer in men (16.5%), followed by bladder cancer (10.2%). It is in view of this that this study is pertinent.
- OBJECTIVE OF THE STUDY
The main objective of this study is to examine the knowledge, attitude and practice of prostate cancer screening among adult men (25 years and above) in Jos North, the specific objectives are:
- To examine the effect of negative attitude to prostate cancer screening practice among adult men on their health
- To examine if there is any significant relationship between knowledge of prostate cancer and screening practice
- To ascertain the role of government in combatting prostate cancer among men of 25 years and above through awareness campaign
- To proffer suggested solution to the identified problem
- RESEARCH QUESTION
The following research questions were formulated by the researcher to aid the completion of the study;
- Does the negative attitude to prostate cancer screening practice among adult men have any effect on their health?
- Is there any significant relationship between knowledge of prostate cancer and screening practice?
- Does government play any role in combatting prostate cancer among men of 25 years and above through awareness campaign?
- RESEARCH HYPOTHESES
The following research hypotheses were formulated by the researcher to aid the completion of the study:
H0: There is no significant relationship between knowledge of prostate cancer and screening practice among adult men
H1: There is a significant relationship between knowledge of prostate cancer and screening practice among adult men
H0: Government does not play any role in combatting prostate cancer among men of 25 years and above through awareness campaign
H2: Government does play a role in combatting prostate cancer among men of 25 years and above through awareness campaign
- SIGNIFICANCE OF THE STUDY
It is believed that at the completion of the study, the findings will be of great importance to the Nigerian cancer society, as the findings will be of great importance to the agency to aid them to promote awareness about the dangers of prostate cancer among adult men. The study will also be of great importance to medical student and public health who intend to embark on a study in a similar topic, as the findings will serve as a reference point to further studies. The study will also be of great importance to students, teachers, researchers, lecturers, academia’s and the general public as the study will contribute to the pool of existing literature on the subject matter and also contribute to knowledge.
- SCOPE AND LIMITATION OF THE STUDY
The scope of the study covers the knowledge, attitude and practice of prostate cancer screening among adult men ( 25 years and above) in Jos North. But in the course of the study, there are some factors that limit the scope of the study;
AVAILABILITY OF RESEARCH MATERIAL: The research material available to the researcher is insufficient, thereby limiting the study
TIME: The time frame allocated to the study does not enhance wider coverage as the researcher has to combine other academic activities and examinations with the study.
FINANCE: The finance available for the research work does not allow for wider coverage as resources are very limited as the researcher has other academic bills to cover.
- OPERATIONAL DEFINITION OF TERMS
Knowledge
Facts, information, and skills acquired through experience or education; the theoretical or practical understanding of a subject
Attitude
A feeling or way of thinking that affects a person's behavior a positive attitude change your attitude
Cancer
Cancer is a large group of diseases that can start in almost any organ or tissue of the body when abnormal cells grow uncontrollably, go beyond their usual boundaries to invade adjoining parts of the body and/or spread to other organs
Prostate cancer
A cancer in a man's prostate, a small walnut-sized gland that produces seminal fluid
1.9 ORGANIZATION OF THE STUDY
This research work is organized in five chapters, for easy understanding, as follows
Chapter one is concern with the introduction, which consist of the (overview, of the study), statement of problem, objectives of the study, research question, significance or the study, research methodology, definition of terms and historical background of the study. Chapter two highlight the theoretical framework on which the study its based, thus the review of related literature. Chapter three deals on the research design and methodology adopted in the study. Chapter four concentrate on the data collection and analysis and presentation of finding. Chapter five gives summary, conclusion, and recommendations made of the study.
