Prostate cancer knowledge and barriers to screening among men at risk in northern Tanzania: A community-based study

Background Although prostate cancer (Pca) screening plays important role in early diagnosis and reduction of mortality, Tanzanian men are relatively unscreened. We aimed to investigate Pca knowledge level and barriers to Pca screening among at-risk men in northern Tanzania. Methods This community-based survey was conducted in northern Tanzania from May to September 2022, involving men age ≥40 years. Participants were invited by announcing in local churches, mosques, brochures, and social media groups. Participants attended a nearby health facility where survey questionnaires were administered. Knowledge level was measured on the Likert scale and scored as poor (<50%) or good (≥50%). Results A total of 6205 men with a mean age of 60.23 ± 10.98 years were enrolled in the study. Of these, 586 (9.5%) had ever been screened for Pca. Overall, 1263 men (20.4%) had good knowledge of Pca. Having health insurance, knowing at least 1 risk factor or symptoms of Pca, and hospital as the source of Pca information were significantly associated with ever being screened. The most common reasons for not being screened were a belief that they are healthy (n = 2983; 53.1%), that Pca is not a serious disease (n = 3908; 69.6%), and that digital rectal examination (DRE) as an embarrassing (n = 3634; 64.7%) or harmful (n = 3047; 54.3%) procedure. Conclusion Having Pca knowledge, health insurance and hospital source of information were correlated with increased screening. False beliefs about DRE and the seriousness of Pca had negative effects on screening. Increasing community knowledge and universal health coverage would improve uptake of Pca screening.