Prostate Cancer Screening: What African Men Need to Know

By Oluwasola Samuel, Freelance health writer. Medically reviewed by: A. Odutola MB.BS, PhD, FRCSEd.

Image of a biological sample collecting vial with red stopper and a label reading “Prostate cancer test”. The vial contains blood and it’s held in a blue gloved hand against a background with a laboratory request form, a light blue ribbon and the caption: “Get checked”

 

Highlights

• Prostate cancer is the most common cancer in African men.

• Over 70% are diagnosed late, when treatment is less effective.

• Family history increases risk 2–3 times, yet awareness is still low.

• Prostate cancer is the most commonly diagnosed cancer among men in Sub?Saharan Africa and the leading cause of cancer-related death in that population.

 

Introduction 

In May 2025, the then U.S. President, Joe Biden, was diagnosed with prostate cancer. The disease was reported in the media to have spread to his bones. His case has sparked global conversations about the importance of early prostate cancer screening, especially among older men.

Prostate cancer screening could be the one step that saves your life, or the life of someone you love. Sadly, prostate cancer in African men is often detected too late. It is not because it's untreatable but because many never get screened early enough.

In many African countries, prostate cancer is the most commonly diagnosed cancer among men over 50. [1] The numbers are rising, but the good news is that early detection makes a huge difference. If caught early, prostate cancer can be managed and often cured. You are not alone if this topic feels new, confusing, or frightening. 

This blog will walk you through everything you need to know about why prostate cancer screening matters, how it’s done, when to get tested, and how to overcome the fears and stigma.

 

What's prostate cancer?

Prostate cancer is a type of cancer that affects the prostate gland. The prostate is a small gland that is about the size of an average kolanut (4-5 cm or 1.5 to 2 inches in diameter). It is only found in men. The prostate gland is located just below the bladder (see fig. 1). The bladder is deep down in the front part of your lower abdomen in an area called the pelvis. It collects and stores your urine before you pass it out. 

Fig. 1: Showing the location of the prostate gland below the bladder with a cancer growth shown. Click on the image to enlarge. Credit.

 

The prostate gland plays a key role in producing the fluid that helps carry, protect and nourish semen during ejaculation. It also helps in controlling the outflow of urine from the body.  As men get older, the prostate can sometimes develop problems, one of the most serious being prostate cancer.

Prostate cancer occurs when abnormal cells grow in the prostate gland. These abnormal cells start to multiply out of control. Some prostate cancers grow slowly and might not cause serious problems, but others can spread quickly if not found early.

Prostate cancer in African men is more common and often more aggressive. Scientists believe this may be linked to a mix of genetics, late diagnosis, and lack of awareness. [2] Many African men don’t talk openly about their health, and are often culturally misinformed, causing symptoms to be ignored or missed.  

But knowledge is power and you deserve to know what’s going on in your body, know the symptoms, understand the risks, and learn about prostate cancer screening. This can help make a difference and create awareness about prostate cancer screening.

 

Burden of prostate cancer in Africa

Fig. 2: Info poster on estimated burden of prostate cancer among all male cancers in Sub-Saharan Africa 

 

Prostate cancer is a growing problem in many Sub-Saharan countries. Although it's under-reported in many African countries, studies show prostate cancer is one of the most common types of cancer affecting men in Sub-Saharan countries. [3] Prostate cancer has been reported to account for approximately 23% of all male cancers in the region (fig. 2). [4] In many cases, this condition remains undiagnosed or detected late.

African men or people of African descent are mostly at greater risk of prostate cancer. [5] They also face worse outcomes compared to others in other regions (Europe, Asian, North America, and Latin America). There are little data around prostate cancer in Africa. 

According to GLOBOCAN 2020 and other related studies, Africa has the highest death rate for cancers like prostate cancer. [6] This means men diagnosed with the condition are much more likely to die from it compared to men in other regions of the world.

 

What's prostate cancer screening?

Table 1: showing prostate cancer screening recommendations for Sub-Saharan African men. Click on the image to enlarge.

 

Prostate cancer screening is a medical check-up done to look for the early signs (presence) of prostate cancer before symptoms appear. It usually involves these two common procedures: [7] See Table 1.

• A laboratory test for Prostate-Specific Antigen (PSA), which is (PSA) blood test to measure the level of a an enzyme associated with the prostate gland
• A Digital Rectal Exam (DRE) where a doctor puts a finger into your rectum (back body) to feel and check your prostate for anything unusual. [7] 

While the goal of screening is to detect and treat cancer early for the best outcome, you should discuss the risk of over diagnosis and over treatment with your doctor. 

 

Who should and when to get screened for prostate cancer?

You should get screened from age: (see Table 1)

• 50 or older if an African man with average risk
• 40 - 45 if you are at high risk; i.e. you have a family history of prostate cancer, especially in a father, uncle or brother.

But there isn’t a one-size-fits-all approach. It’s important to reach out and discuss with your healthcare professional (oncologist or urologist) about your risk. They will help you decide the right time for screening based on your risk factors, overall prostate health, and medical history.

 

Common symptoms of prostate cancer

Prostate cancer often develops silently, especially in its early stages and may not cause any symptoms. When it causes symptoms, it's so important to know what to look out for, so you can catch it early and take action.

Here are some common prostate cancer symptoms to be aware of:

• Frequent urination, especially at night (called nocturia).

• Finding it difficult to start or stop urine, or a weak urine stream.

• Feeling pain or burning sensation during urination or ejaculation. 

• Blood in urine or semen (looks pink, or red).

• Pelvic discomfort or pain, including lower back or hip.

• Erectile dysfunction or changes in sexual performance.

Some of these symptoms are similar to those of a non-cancerous prostate enlargement (Benign Prostatic Hyperplasia). Your doctor will help to identify whether your symptoms are caused by prostate cancer or not.

 

Challenges and solutions of prostate cancer screening in African communities

Table 2: A llist of barriers/chllenges to prostate cancer screening in Sub-Saharan African men. Click on image to enlarge.

 

Some challenges make it difficult to carry out prostate cancer screening in Africa (See Table 2).

These challenges are not limited to rural areas alone; they are also present in urban areas. 

Here are some of the barriers or challenges: [8]

1. Low awareness and knowledge: 

Many Africans are not aware of the need, risk factors, symptoms, or the benefits of early screening.They are also not aware of where to get screened. This lack of awareness hinders or delays them from seeking help until the cancer has advanced and become very late for good treatment outcome. Well-structured public education should help to improve community awareness.

2. Cultural beliefs and stigma: 

In some communities in Africa, for men to discuss health issues openly is generally considered a taboo because of the fear of being perceived as weak or not manly. The taboo prevents them from getting screened early. Also, many African men have considerable misperception of what causes cancer, with many believing that it is a spiritual attack or a curse. These cultural ibeliefs cause delay in seeking hel and community targeted public education campaigns should help to reverse the problem gradually.

3. Healthcare access issues: 

Many African regions have limited healthcare infrastructure. Screening facilities may be far away, poorly equipped, or understaffed. These factors limit access, availability and quality of prostate cancer screening that can be done. African governments and other policy stakeholders need to provide adequate funding for the improvement of healthcare infrastructure generally.

4. Economic barriers: 

Screening and treatment can be expensive. In many low-income countries like in Africa, where health insurance is not well established, a significant part of the cost of care is generally paid out-of-pocket. So those with low income forgo or delay seeking medical care including screening for prostate cancer. The introduction of low cost social health insurance would be helpful to reduce the role of economic barriers in health seeking behaviour.

5. Inadequate trained professionals: 

Few trained specialists are available to conduct screenings, interpret results, and provide follow-up care, which reduces screening efficacy. Improvement in training of primary care and specialist staff is needed.
 

What you can do today

Prostate cancer is beatable only if you catch it early. To do that, you need to get screened early. Prostate cancer might sound scary but what’s even scarier is doing nothing.

So, here are what you can do today:

• Talk to a healthcare professional — whether you feel fine or healthy or you feel you might have any related symptoms, talk to your healthcare professional (oncologist or urologist) about prostate cancer screening at every opportunity.

• Encourage the men around you — educate and encourage your father, uncle, brother, and friend to get screened.

• Speak up in your community gatherings — when you have the opportunity to speak in a large gathering in your community, let people know the importance of early prostate cancer screening.

Always remember that awareness and action save lives.

 

Conclusion

‎Prostate cancer is not a death sentence, especially when caught early. The truth is, early screening can be the difference between living a quality life and dying from a readily treatable and preventable cause. Every African man deserves the chance to live a long, healthy life without being held back by stigma, or fear. Whether you are experiencing symptoms or feel perfectly fine, getting screened is a smart and positive step toward protecting your health.‎

‎Now that you have all the information you need, do something with it. Talk to your healthcare professional, and encourage the men in your life to get screened today. 

 

Frequently asked questions 

1. How do I know if my prostate is okay?

A good way to know if your prostate is okay is to get it checked by your healthcare professional (oncologist or urologist), especially if you're over 40 years old. They might recommend a simple blood test called PSA and sometimes a digital rectal exam. 

If you're not having any problems like trouble peeing, frequent urination at night, or pain, that’s a good sign. However, regular check-ups are still the best way to be sure.

2. What is the normal PSA test result?

There’s no single PSA number that tells you for sure if something is wrong. A higher PSA doesn’t always mean cancer, but the chances go up as the number gets higher.

Usually, a PSA above 4.0 ng/mL is seen as high, and your doctor might suggest more tests such as a biopsy. [10] That said, PSA levels can go up with age, so doctors may use different limits depending on how old you are.

3. Can excessive alcohol cause prostate cancer problems?

Drinking too much alcohol doesn’t directly cause prostate cancer, but it can negatively affect your overall health and may raise your risk of many health conditions such as prostate problems. 

If you must drink, it is best to drink in moderation and keep a healthy lifestyle.

4. At what age should I go for prostate cancer screening?

A good time to start thinking about prostate cancer screening is around age 50 years if you are at average risk. But if you’re a black African or have a family history of prostate cancer, it's better to start earlier, around age 40 or 45. It's best to talk to your healthcare professional (oncologist or urologist) about what’s right for you.

 

References

1. Graham LS, Lin JK, Lage DE, Kessler ER, Parikh RB, Morgans AK. Management of prostate cancer in older adults. American Society of Clinical Oncology Educational Book. 2023 May;(43):e390396. doi: 10.1200/EDBK_390396. Available from here.

2. Junejo NN, AlKhateeb SS. BRCA2 gene mutation and prostate cancer risk. Comprehensive review and update. Saudi Med J. 2020 Jan;41(1):9-17. doi: 10.15537/smj.2020.1.24759. Available from here.

3. Nn J, Ss A. BRCA2 gene mutation and prostate cancer risk. Comprehensive review and update. Saudi medical journal [Internet]. 2020 Jan [cited 2025 Jul 26];41(1). Available here.

4. National Cancer Institute. What is cancer? [Internet]. Updated 2021 October 11. [Cited 2025 Jul 26]. Available from here.

5. Musekiwa A, Moyo M, Mohammed M, Matsena-Zingoni Z, Twabi HS, Batidzirai JM, et al. Mapping evidence on the burden of breast, cervical, and prostate cancers in Sub-Saharan Africa: A scoping review. Front Public Health. 2022 Jun 16. 10:908302. doi: 10.3389/fpubh.2022.908302.Available from here.

6. Chinegwundoh F. Higher risk of prostate cancer in men of African heritage [Internet. n.d.]. Prostate Matters. [Cited 2025 Jul 26]. Available from here.

7. Sharma R, Aashima, Nanda M, Fronterre C, Sewagudde P, Ssentongo AE, et al. Mapping cancer in Africa: A comprehensive and comparable characterization of 34 cancer types using estimates from Globocan 2020. Front Public Health. 2022 Apr 25.10:839835. doi: 10.3389/fpubh.2022.839835 . Available from here.

8. National Cancer Institute. Prostate-specific antigen (PSA) test. [Internet].Updated 2025 Jan. 31. [Cited 2025 Jul 26]. Available from here.

9. Baratedi WM, Tshiamo WB, Mogobe KD, McFarland DM. Barriers to Prostate Cancer Screening by Men in Sub-Saharan Africa: An Integrated Review. J. Nurs. Scholarship. 2020, 52(1);85-94. doi: 10.1111/jnu.12529. Available from here.

 

Related:

Prostate cancer in African men: Symptoms, Causes, and Risk Factors

Prostate Enlargement in African Men: Causes, Symptoms and Complications

Diagnosis and Treatment of Prostate Enlargement: A Guide for Africans

 

Published: August 6, 2025

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