Awareness about prostate cancer and its screening in Medina, Jeddah, and Makkah, Saudi Arabia population



  Table of Contents ORIGINAL ARTICLE Year : 2022  |  Volume : 14  |  Issue : 1  |  Page : 27-32  

Awareness about prostate cancer and its screening in Medina, Jeddah, and Makkah, Saudi Arabia population

Ahmed F Jarb1, Amjad Kh Aljuaid2, Shauge M Alghamdi3, Ali A Almathami4, Abdulaziz A Altawili5, Anwar Alesawi6
1 Faculty of Medicine, Fakeeh College for Medical Sciences, Jeddah, Kingdom of Saudi Arabia
2 Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
3 Faculty of Medicine, Ibn Sina National College, Jeddah, Kingdom of Saudi Arabia
4 Faculty of Medicine, Umm Al-Qura University, Al Qunfudhah, Kingdom of Saudi Arabia
5 Faculty of Medicine, Tabuk University, Tabuk, Kingdom of Saudi Arabia
6 Consultant Urologist, Uro-Oncologist, MIS and Robotic Urologist at Fakeeh Care, Fakeeh College of Medical Sciences, Jeddah, Kingdom of Saudi Arabia

Date of Submission26-Jun-2021Date of Acceptance24-Sep-2021Date of Web Publication28-Dec-2021

Correspondence Address:
Mr. Ahmed F Jarb
Faculty of Medicine, Fakeeh College of Medical Sciences, Jeddah
Kingdom of Saudi Arabia
Login to access the Email idCrossref citationsCheck

DOI: 10.4103/ua.ua_113_21

Rights and Permissions

   Abstract 


Background: Prostate cancer (PCa) is a global burden on public health; it has been ranked as the second common cancer worldwide, with 1.3 million new cases in 2018. Developed countries have a higher incidence than in developing countries. Because of the lack of studies on PCa in Saudi Arabia, our study aims to measure the awareness about PCa and knowledge of PCa screening practices among men in Medina, Jeddah, and Makkah, Saudi Arabia.
Methodology: A cross-sectional study conducted among males in Medina, Jeddah, and Makkah, Saudi Arabia, from 2nd to 10th July 2020, using a validated questionnaire. The sample size was 1212 participants. Data collected through an online questionnaire. All data analyses performed using (SPSS) software, using the Chi-square test for bivariate analysis. All levels of significance were set at P < 0.05.
Results: We collected 1212 completed surveys, with mean ages of 36 years (standard deviation ± 12.77). We found that 77% of participants heard about PCa, and 52.5% heard about PCa screening tests. This study showed that only 10.6% of all participants had good knowledge, 41.9% had fair knowledge, and 47.5% had poor knowledge. Only 3.9% of participants had experienced the prostate-specific antigen test.
Conclusion: The study showed that the level of knowledge of PCa is low. Thus, community and individuals should collaborate to increase awareness by having more awareness campaigns, disseminating the information through the media, and encouraging men to do screening tests as indicated. In addition, including more Saudi Arabia cities in future studies is preferable to have more precise outcomes.

Keywords: Awareness, cancer, Jeddah, KSA, Makkah, Medina, prostate, prostate cancer, Saudi Arabia, screening


How to cite this article:
Jarb AF, Aljuaid AK, Alghamdi SM, Almathami AA, Altawili AA, Alesawi A. Awareness about prostate cancer and its screening in Medina, Jeddah, and Makkah, Saudi Arabia population. Urol Ann 2022;14:27-32
How to cite this URL:
Jarb AF, Aljuaid AK, Alghamdi SM, Almathami AA, Altawili AA, Alesawi A. Awareness about prostate cancer and its screening in Medina, Jeddah, and Makkah, Saudi Arabia population. Urol Ann [serial online] 2022 [cited 2022 Jan 21];14:27-32. Available from: 
https://www.urologyannals.com/text.asp?2022/14/1/27/333901    Introduction Top

Prostate cancer (PCa) is a global burden on public health; it has been ranked as the second common cancer worldwide, with 1.3 million new cases in 2018.[1] The incidence rate of PCa varies across the world, where developed countries have a higher incidence rate than those from developing countries.[2] This variation might be due to prostate-specific antigen (PSA) testing.[3]

By 2030, the new cases of PCa predicted to increase to 1700,000 worldwide per year, with around 500,000 deaths due to this disease.[4] Recommendations advised screening for PCa by digital rectal examination and PSA testing. Starting the screening at the age of 40 for specific populations provides the only way to reduce mortality from cancer.[5],[6] It is well known that early detection of certain grades of PCa leads to a higher remission rate. Hence, public awareness and knowledge of PCa risk factors and red flags are necessary.[7]

According to the World Health Organization, fatality percentages and the incidence of PCa, specifically in the Arab region, have been increased and anticipate that the numbers will increase.[8] Although in the Arab area, in contrast to the USA, PCa in advanced stages and spread progression were noticed to be more presented.[9],[10] PCa showed a lower mortality rate by 40% since 1990 in the USA and thought to be due to good screening practices and enhancing treatment.[11] In Saudi Arabia, PCa has become the second most common cancer among males who are older than 60 years old.[12] Referred to an age-standardized incidence rate of PCa between 2001 and 2008, it was estimated to be 5.1 cases per 100,000 males in Saudi Arabia.[13]

A study done in Jamaica, revealed that 88% of the participants have a positive attitude towards screening of PCa and to prevent it, while 84% have moderate knowledge of PCa.[14] Moreover, a study done in Turkey showed that 88.4% of the participant know that PCa is a treatable disease if diagnosed early.[15] Another study in 2017 in Italy showed that 82.1% of participants informed them that they heard about PCa previously, and 31.8% of them have heard about PCa from a doctor.[16]

In addition, in Kenya, there was a high level of awareness in about 80% of the respondent.[17] Furthermore, a study done in Nigeria showed that 47.3% of the participants were aware about PCa.[18]

On the other hand, a study done in Turkey showed that 20.75% participants had heard previously about the PSA test, and only (5.03%) of participants did the screening program regularly.[19]

According to a comparative multicenter study in Saudi Arabia, Egypt, and Jordan, the majority of the participants had poor knowledge and fair attitude toward PCa examinations and screening practices.[20] Moreover, another study done in Oman showed that 90.8% of participants did not know that PCa is one of the most prevalent cancers affecting men in Oman.[21] The most recent regional study was done in Riyadh and showed that 82.3% of participants heard about PCa and 37.8% did not know the symptoms of PCa.[22]

According to a study done in Saudi Arabia, the incidence of PCa had increased by 8 folds from 1990 to 2016.[23] In Saudi Arabia, about half of the population is younger than 29 years old. Therefore, we should do more effort and exploration across the rest of the Kingdom to reveal the incidence of cancer and mortality in the society to implement management, screening, and prevention strategies in our country.[23],[24] Because of that and the lack of enough studies about PCa in Saudi Arabia, our study aims to measure the awareness, knowledge, and screening practices of PCa among men in Medina, Jeddah, and Makkah, Saudi Arabia.

   Methodology Top

This study comes with an objective of assessing PCa awareness and knowledge of screening practices among men in Medina, Jeddah, and Makkah, Saudi Arabia. This study was approved by Dr. Soliman Fakeeh Hospital Scientific Research Committee (DSFH IRB). It is a cross-sectional study, carried out in Medina, Jeddah, and Makkah, Saudi Arabia, from the 2nd of July to 10th, 2020. A sample size of 1212 participants, comprising of males aged 18 years old or older who agreed to participate, were included in this study. Those who had been excluded were males who had been diagnosed with PCa before.

A valid well-structured questionnaire, adapted from a previous study, was used after obtaining consent from all participants.[25] The questionnaire was initially in English, translated to Arabic, as Arabic is the native language for the majority of the population in Saudi Arabia. The translation process is done under the supervision of a specialist in this field, and to ensure the successfulness of the translation process, the survey was disseminated to 25 volunteers who were excluded after they answered the questionnaire. Finally, we asked them if they understand the questions easily and correctly to make sure that the translated version is clear.

The questionnaire was sectioned to sociodemographic characteristics (age, sex, nationality, place of origin, marital status, educational level, family history of PCa, and previous diagnosis of PCa), knowledge of PCa, and screening practices.

On a scale of 0–15, participants' knowledge of PCa was graded. One point was given for a correct response, while an incorrect response or I don't know answers earned no points. Those who scored ≥11 of 15 points were considered to have “good” knowledge; those who scored 6–10 of 15 points were graded as having “fair” knowledge, while those who scored <6 of 15 points were graded as having “poor” knowledge.

Data were collected through an online questionnaire distributed to the general population living in Medina, Jeddah, and Makkah. Collected data were analyzed using the IBM SPSS version 25 computer statistical software package IBM Corp., located in Armonk (N.Y., USA), using a frequency test for univariate analysis, and Chi-square test for bivariate analysis. P =0.05 was used as a cut-off point for significance.

   Results Top

In this study, we aimed to assess the extent of knowledge and attitude of PCa and its screening among men in Medina, Jeddah, and Makkah. The majority of the participants were Saudi (83.3%). Participants' ages ranged from 18 to 77 years old, with a mean age of 36 ± 12.77 years. 75.8% of the participants had an academic education degree. Most of the respondents (94.3%) did not have a family history of PCa [Table 1]. 77.5% of participants heard about PCa and the source of information about PCa was from social media in 40.3% of the population [Figure 1].

Figure 1: The percentage of heard about prostate cancer and how heard about it

Click here to view

Regarding at overall level of knowledge of PCa, almost half of the participants (47.5%) had poor knowledge and 41.9% had a fair knowledge of PCa, while only 10.6% had good knowledge of the disease [Figure 2]. There was no significant difference between total knowledge score across all demographic data variables except for the educational level and marital status, with a P value of 0.004 and 0.033, respectively [Table 2], which means that higher education and married have more knowledge compared to the rest of demographic data.

Looking at the general knowledge of PCa, we found that 69.7% did not know the risk factors of PCa and only 34.1% know the signs and symptoms of PCa [Table 3]. There is no significant relationship between risk factors and signs and symptoms with all demographic variables except education level and marital status [Table 4], and this show that higher education and married have more awareness about the risk factor, signs, and symptoms of PCa.

Table 4: Between-demographic differences and risk factor, sign and symptom, and screening

Click here to view

Coming to the awareness about screening practices of PCa, we found that 80.9% of respondents did not know the screening tests for PCa and about half (52.2%) of the participants had heard about PCa screening tests [Figure 3]. Furthermore, 3.9% of the participants had experienced the PSA test, and 43% of them had it once.

Figure 3: The percentage of heard about prostate cancer screening test and the knowledge level about it

Click here to view

Moreover, about two-thirds of tested participants (62.5%) had a PSA test because their doctor recommended it for them. 86% of participants who did not have been tested before, the cause was that they were not aware of the PSA test or they thought that they did not need to have the test. Besides, there is no significant association between knowledge of screening practices and all demographic variables, apart from a significant relationship with a family history of PCa (P > 0.001) and with educational level (P = 0.02) [Table 4]. The positive family history of PCa and higher education are reasons to increase knowledge of screening practices.

   Discussion Top

This study assessed awareness of PCa and knowledge about screening practices among men in Medina, Jeddah, and Makkah, Saudi Arabia. Although the second most common cancer that affects Saudi men aged 60 and above is PCa.[12] However, the levels of the overall knowledge of PCa in this study were low in 47.5% and the awareness of PCa screening test was not known in 80.9%, despite that the majority (77.5%) of the responders heard about PCa and 52.2% heard about PCa testing before.

Our results are in consonance with the findings in a study conducted in Riyadh city, which reported that the knowledge of PCa was poor with a fair attitude toward examination and screening.[26] These findings do not differ from a more extensive study conducted in Saudi Arabia, Egypt, and Jordan which showed poor knowledge and fair attitude toward PCa examination and screening practices.[20] Similar findings have also emerged from other countries such as Tanzania and Nigeria, indicating their poor knowledge about PCa and its screening.[25],[27]

As noted in our study and previous ones, sociodemographics and educational levels have been found to positively impact awareness and overall knowledge of PCa.[15],[22],[28] Surprisingly, only 15.9% of our participants who have a positive family history of PCa had good knowledge. This lack of knowledge of PCa necessitates putting efforts into educating men for decision-making regarding PCa screening activities.

It is well established that poor knowledge is one of the reasons for low PSA testing.[29] According to a study held in Jamaica, men sampled at a mass screening clinic found to have moderate knowledge about PCa.[14] As we believe, good knowledge has influenced their attitude toward screening. This may explain our result where only 3.9% of the participants had been screened for PCa. Apart from that, 58.2% of our participants were aware of that positive family history of PCa is considered a risk factor; moreover, 19.1% of participants who had been screened, had a family history of PCa.

Moreover, among the reasons for participants' abstinence of screening, revert to their own believes, as most of them do not think that they are at high risk for PCa. A similar finding has been observed in a study conducted in Italy, and this could be due to the mean ages included in both studies, as 79.5% of the participants who think that they are not at risk were younger than 46 years old.

In this study, the participants stated that the vast amount of their PCa knowledge came from using social media, an effective intervention for health promotion, especially for certain populations who are more likely to be disadvantaged, for instance, youth, older age, low socioeconomic status, and rural areas.[30] However, social media's benefits in changing an individual's behaviors remain debated.[31]

On the other hand, a crucial finding from this study was that only 13% of the participants gained information from a health-care worker, which questions the physicians' practices of PCa screening and counseling. A study held in Saudi Arabia found physicians' knowledge and attitude toward this issue was not good. Therefore, only 54% were practicing PCa counseling and screening.[16]

This is a cross-sectional study and, consequently, comes with limitations inherent to this study design. Furthermore, data collection was based on an online questionnaire, resulting in limited sampling, as reaching a certain population will be more difficult, elderly, for example, have limited access to online surveys. Studies with a larger group of men in different geographic areas are indeed recommended.

   Conclusion Top

The study showed that the level of knowledge and awareness of PCa is low. Thus, community and individuals should collaborate to increase the awareness and knowledge level by having more awareness campaigns, disseminating information through social media, and encouraging men to do screening tests as it helps in early detection. In addition, including more cities of Saudi Arabia in future studies is preferable to have more precise outcomes.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 

   References Top
1.Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 2019;144:1941-53.  Back to cited text no. 1
    2.Rawla P. Epidemiology of prostate cancer. World J Oncol 2019;10:63-89.  Back to cited text no. 2
    3.Quinn M, Babb P. Patterns and trends in prostate cancer incidence, survival, prevalence and mortality. Part I: International comparisons. BJU Int 2002;90:162-73.  Back to cited text no. 3
    4.Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-917.  Back to cited text no. 4
    5.Etzioni R, Legler JM, Feuer EJ, Merrill RM, Cronin KA, Hankey BF. Cancer surveillance series: Interpreting trends in prostate cancer-Part III: Quantifying the link between population prostate-specific antigen testing and recent declines in prostate cancer mortality. J Natl Cancer Inst 1999;91:1033-9.  Back to cited text no. 5
    6.Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med 2009;360:1320-8.  Back to cited text no. 6
    7.Release P. International agency for research on cancer. Asian Pac J Cancer Prev 2003;4:3-4.  Back to cited text no. 7
    8.Sheets F. All Cancers (excluding non-melanoma skin cancer) Estimated Incidence. Mortality and Prevalence Worldwide in. 2012.  Back to cited text no. 8
    9.Osman E, Gomha MA, Harb A, Aldayel A, Aloraifi I, Almousa R, et al. An early-detection programme for prostate cancer in Saudi men: A call from a tertiary-care centre in the Eastern province. Arab J Urol 2014;12:187-91.  Back to cited text no. 9
    10.Salim EI, Moore MA, Al-Lawati JA, Al-Sayyad J, Bazawir A, Bener A, et al. Cancer epidemiology and control in the arab world – Past, present and future. Asian Pac J Cancer Prev 2009;10:3-16.  Back to cited text no. 10
    11.Siegel RL, Jemal A, Wender RC, Gansler T, Ma J, Brawley OW. An assessment of progress in cancer control. CA Cancer J Clin 2018;68:329-39.  Back to cited text no. 11
    12.Wafa AA. Kingdom of Saudi Arabia Saudi Health Council National Health Information Center Saudi Cancer Registry Cancer Incidence Report Saudi Arabia Pre pared by Reviewed by; 2016.  Back to cited text no. 12
    13.Alghamidi IG, Hussain II, Alghamdi MS, El-Sheemy MA. The incidence rate of prostate cancer in Saudi Arabia: An observational descriptive epidemiological analysis of data from the Saudi Cancer Registry 2001-2008. Hematol Oncol Stem Cell Ther 2014;7:18-26.  Back to cited text no. 13
    14.Morrison BF, Aiken WD, Mayhew R, Gordon Y, Odedina FT. Prostate cancer knowledge, prevention, and screening behaviors in Jamaican men. J Cancer Educ 2017;32:352-6.  Back to cited text no. 14
    15.Turkan S, Doğan F, Ekmekçioğlu O, Çolak A, Kalkan M, Şahin Ç. The level of knowledge and awareness about prostate cancer in the Turkish male and the relevant effective factors. Turk J Urol 2016;42:134-9.  Back to cited text no. 15
    16.Morlando M, Pelullo CP, Di Giuseppe G. Prostate cancer screening: Knowledge, attitudes and practices in a sample of men in Italy. A survey. PLoS One 2017;12:e0186332.  Back to cited text no. 16
    17.Wachira BW, Meng'anyi LW, Mbugua GR. Knowledge, Perception and Uptake of Prostate Cancer Screening: A Cross Sectional Study at a Level III Hospital in Kenya; 2018.  Back to cited text no. 17
    18.Ogundele SO, Ikuerowo SO. A survey of the awareness of prostate cancer and its screening among men attending the outpatient clinics of a tertiary health center in Lagos, Nigeria. Niger J Surg 2015;21:115-8.  Back to cited text no. 18
  [Full text]  19.Sungur M, Caliskan S. Awareness of prostate cancer diagnosis and management among Turkish males: A cross sectional study from Çorum. Aging Male 2020;23:202-5.  Back to cited text no. 19
    20.Arafa MA, Rabah DM, Wahdan IH. Awareness of general public towards cancer prostate and screening practice in Arabic communities: A comparative multi-center study. Asian Pac J Cancer Prev 2012;13:4321-6.  Back to cited text no. 20
    21.Al-Azri M, Al-Hinai AS, Al-Ghafri MH, Panchatcharam SM. Knowledge and awareness of prostate cancer among Omani men attending a teaching hospital. J Cancer Educ 2020;35:1002-10.  Back to cited text no. 21
    22.Almuhanna AM, Alshammari S, Alsalman HK, Albeladi H, Alsubaie A, Abueissa WA, et al. Awareness of prostate cancer, screening and methods of managements in a hospital in Riyadh, Saudi Arabia. Egypt J Hosp Med 2018;70:1090-2.  Back to cited text no. 22
    23.Althubiti MA, Nour Eldein MM. Trends in the incidence and mortality of cancer in Saudi Arabia. Saudi Med J 2018;39:1259-62.  Back to cited text no. 23
    24.General Authority for Statistics. Demography Survey 2016; 2016.p. 207. Available from: http://www.stats.gov.sa/sites/default/files/ar-demographic-research-2016_0.pdf [Last accessed on 2021 Oct 28].  Back to cited text no. 24
    25.Awosan KJ, Yunusa EU, Agwu NP, Taofiq S. Knowledge of prostate cancer and screening practices among men in Sokoto, Nigeria. Asian J Med Sci 2018;9:51-6.  Back to cited text no. 25
    26.Arafa MA, Farhat KH, Rabah DM. Knowledge and attitude of the population toward cancer prostate Riyadh, Saudi Arabia. Urol Ann 2015;7:154-8.  Back to cited text no. 26
[PUBMED]  [Full text]  27.Bugoye FC, Leyna GH, Moen K, Mmbaga EJ. Knowledge, perceived risk and utilization of prostate cancer screening services among men in Dar Es Salaam, Tanzania. Prostate Cancer 2019;2019:2463048.  Back to cited text no. 27
    28.Oliver JS, Allen RS, Eichorst MK, Mieskowski L, Ewell PJ, Payne-Foster P, et al. A pilot study of prostate cancer knowledge among African American men and their health care advocates: Implications for screening decisions. Cancer Causes Control 2018;29:699-706.  Back to cited text no. 28
    29.Odedina FT, Campbell ES, LaRose-Pierre M, Scrivens J, Hill A. Personal factors affecting African-American men's prostate cancer screening behavior. J Natl Med Assoc 2008;100:724-33.  Back to cited text no. 29
    30.Welch V, Petkovic J, Pardo Pardo J, Rader T, Tugwell P. Interactive Social Media Interventions to Promote Health Equity: An Overview of Reviews. Vol. 36. Health Promotion and Chronic Disease Prevention in Canada. Public Health Agency of Canada; 2016. p. 63-75.  Back to cited text no. 30
    31.Neiger BL, Thackeray R, Van Wagenen SA, Hanson CL, West JH, Barnes MD, et al. Use of social media in health promotion: Purposes, key performance indicators, and evaluation metrics. Health Promot Pract 2012;13:159-64.  Back to cited text no. 31
    
  [Figure 1], [Figure 2], [Figure 3]
 
 
  [Table 1], [Table 2], [Table 3], [Table 4]
  Top

留言 (0)

沒有登入
gif