Charles Waihenya, Daniel Kinyuru Ojuka, Camille Ragin, Charnita Zeigler-Johnson, Regina Wachuka Mbugua, S. M. Thumbi
Prostate cancer is the leading cause of cancer mortality among Kenyan men, with the majority diagnosed at advanced stages. This pattern likely reflects a combination of health system constraints, delayed diagnosis, and aggressive tumour biology. Prostate Specific Antigen (PSA) level, tumour stage, and WHO/ISUP grade groups are key clinical markers, yet their interrelationships and collective potential to inform risk stratified care remain poorly characterized in Kenyan populations. We conducted a cross-sectional analysis of men with histologically confirmed prostate cancer enrolled in the International Registry for Men with Advanced Cancer (IRONMAN) and African Cancer Genomic Registry (ACGR) registries at two tertiary hospitals in Nairobi Kenyatta National Hospital (KNH) and MP Shah Hospital). Baseline PSA, tumour stage, and ISUP grade groups were abstracted from registry records. PSA values were available for 152 men, while ISUP grade groups for 168 and stage data were available for 170 men included in the stage-stratified analysis. Descriptive analyses and cross-tabulations were used to characterize the distribution and associations of these markers across localized vs. advanced disease. Of the 170 men included in the analysis, 26 (15.3%) presented with localized disease, while 144 (84.7%) had locally advanced or metastatic disease at diagnosis. PSA levels exhibited a strong gradient across tumour stages, with the likelihood of advanced disease increasing progressively with rising PSA categories. Men with PSA above 50 ng/mL predominantly presented with advanced-stage disease at 88%,. ISUP grade groups followed a parallel trend. The grades groups demonstrated a similar association with tumour stage, with lower-grade tumours more commonly observed among men with localized disease and higher-grade tumours predominating among advanced-stage cancers. The WHO/ISUP grade group 3 pattern was strongly associated with advanced disease at presentation. Collectively, these findings suggest that both late diagnosis and aggressive tumour biology contribute to the predominance of advanced-stage prostate cancer in this cohort. PSA Categories demonstrated strong associations with tumour stage at diagnosis in Kenyan men with prostate cancer. Localized disease was uncommon, whereas advanced-stage presentation was frequently accompanied by markedly elevated PSA levels and high-grade histological features. These findings highlight the need for earlier diagnosis and improved access to timely diagnostic and referral pathways in Kenya.
Florencia Moreno, Maria Agustina Chaplin, Mariana Nana, María Graciela Abriata
Population-based cancer registries are essential tools for monitoring the burden of childhood cancer and guiding evidence-based public health policies. In pediatric oncology, long-term registry data are particularly valuable for evaluating survival trends, identifying inequities, and informing health system strengthening. The Argentina Oncopediatric Registry (ROHA), established in 2000, provides a unique framework for evaluating long-term trends in childhood cancer incidence, survival, and mortality. We analyzed population-based data from ROHA for children aged 0–14 years diagnosed with cancer(2000-2022).Incidence was calculated using age-standardized rates (ASR). Overall survival(OS) was estimated using standard survival analysis techniques and evaluated by calendar period, tumor group, geographic region, and Human Development Index (HDI). National mortality data were obtained from the National Statistical Office. Adolescents aged 15–19 years were excluded due to incomplete registry coverage. During the study period, 31,241 childhood cancer cases were registered, corresponding to an incidence ASR of 131 cases/million children per year, which remained stable over time. Five-year OS improved substantially, increasing from 59.7% in 2000–2004 to approximately 70% in the most recent period. The largest survival gains were observed for leukemias and central nervous system tumors. However, improvements slowed in recent years, and marked disparities persist by tumor type, geographic region, and Human Development Index level. The national age-standardized childhood cancer mortality rate per 100,000 children was 3.73 in 2021–2022 and showed a declining trend over the study period, consistent with improvements in overall survival. Over the past 25 years, Argentina has achieved meaningful progress in childhood cancer survival while maintaining stable incidence rates. Argentina's survival estimates are among the highest reported in Latin America; however, important regional and socioeconomic disparities persist. Integrating high-quality registry data with national cancer policies, social protection mechanisms, and strategies to strengthen clinical support—through the Childhood and Adolescent Cancer Protection Law and the Unique Pediatric Oncology Certificate—offers a model to improve equity, quality of care, and outcomes in Argentina and similar middle-income settings.
Breast cancer remains a significant global health challenge, characterized by high morbidity and mortality rates, particularly in resource-limited settings where access to advanced diagnostic imaging is scarce. In Somaliland, early detection is critical to improving survival outcomes. Breast self-examination (BSE) serves as a vital, cost-effective, and non-invasive screening tool that empowers women to identify early pathological changes. This study investigated the prevalence of BSE practice and its associated sociodemographic, knowledge-based, and attitudinal factors among female medical students in Borama, Somaliland. A university-based cross-sectional study was conducted among 202 female medical students in April–May 2024. Data were collected using a structured self-administered questionnaire through convenience sampling with proportional quotas across selected health science faculties. Data analysis included descriptive statistics and binary logistic regression to identify independent predictors of BSE practice, with statistical significance set at p < 0.05. The findings revealed a high level of knowledge (77.7%) and overall positive attitudes (80.2%) toward BSE. However, the actual prevalence of BSE practice was moderate, only 46.5% (n = 94) of participants had ever performed BSE, and among these, only 51.1% practiced monthly as recommended. Multivariable logistic regression identified attitude as the strongest predictor of practice (OR = 3.251, 95% CI: 1.68–6.29, p < 0.001), followed by age (5.012, p < 0.001), indicating that older students and those with proactive health beliefs were significantly more likely to engage in BSE. Despite high theoretical knowledge, a substantial “knowledge-practice gap” exists. Interventions should transition from purely factual education to attitude-focused behavioral training. Integrating practical BSE demonstrations into university curricula is essential to equip future healthcare professionals with the habits necessary to promote early detection in the wider community.
Prostate cancer is one of the most frequently diagnosed malignancies among men worldwide and represents a growing public health concern in low-and-middle-income countries. In sub-Saharan Africa, including South Africa, the disease is often diagnosed at advanced stages due to limited screening services, delayed referrals, and structural health barriers. Understanding the socio-demographic patterns, point prevalence, and geographic origins of patients presenting with prostate cancer is critical for informing targeted cancer control interventions. This study aimed to describe the socio-demographic characteristics, population point prevalence, geographic distribution, and referral patterns of patients diagnosed with prostate cancer at Nelson Mandela Academic Hospital in South Africa. A quantitative cross-sectional study was conducted using secondary data from medical records of men diagnosed with prostate cancer between March 2020 and December 2021. A total of 224 patient records were reviewed. Variables collected included age, district, and sub-district residence, and referral facility. Patients were categorised into low, intermediate, and high-risk clinical groups. Descriptive statistics and chi-square tests were used to assess associations between geographic variables and disease risk. Geographic distribution was visualised using heat maps. The mean age of participants was 72.6 years (SD ± 8.8). Most patients (61.2%; 95% CI: 54.4%–67.6%) presented with high-risk disease at diagnosis. High-risk disease was most prevalent among patients aged 80 years and older (87.8%; 95% CI: 75.2%–95.4%). The majority of patients originated from the OR Tambo District (75.4%;95% CI: 69.3%–80.9%), particularly the King Sabata Dalindyebo sub-district, followed by Peripheral sub-districts; Amathole District (9.4%; 95% CI: 5.9%–14.0%), Chris Hani District (6.7%; 95% CI: 3.8%–10.8%), Alfred Nzo District (4.9%; 95% CI: 2.5%–8.6%), and Joe Gqabi District (3.6%; 95% CI: 1.6%–6.9 There was no statistically significant association between geographic district and risk category (p = 0.932). Most prostate cancer patients presenting to the teaching hospital were diagnosed with advanced disease, irrespective of geographic location. These findings highlight the need for strengthened early detection strategies, decentralised screening services, improved referral pathways, and targeted community awareness programmes in rural provinces of South Africa.
Benjamin Ansah Dortey, Stanley Kofi Alor, Emmanuel Anongeba Anaba, Charlotte Abra Esime Ofori, Yula Salifu, Henry Ekow Yanney, James Akazili
Breast and cervical cancers are leading causes of morbidity and mortality among women in sub-Saharan Africa, yet screening uptake remains low in Ghana. Sexual autonomy, defined as a woman's ability to negotiate sexual activity and refuse unwanted sex, may influence health-seeking behaviours, including cancer screening. However, evidence on the association between sexual autonomy and screening uptake across rural-urban contexts is limited. This study examined the association between sexual autonomy and uptake of breast cancer (BC) and cervical cancer (CC) screening services among Ghanaian women in rural and urban areas using recent national-level data. We analysed data from a weighted sample of 8,044 women aged 15–49 years in the 2022 Ghana Demographic and Health Survey (GDHS), conducted across all sixteen regions of Ghana. Descriptive statistics, chi-square tests, and multivariable logistic regression analyses were performed using Stata/SE version 17 with complex survey design adjustments. The main outcome measures were self-reported uptake of BC and CC screening services. Sexual autonomy was the primary explanatory variable. Overall, women with sexual autonomy were more likely to screen for BC (AOR = 2.10, 95% CI: 1.68–2.63) and CC (AOR = 1.95, 95% CI: 1.32–2.88). For BC screening, sexually autonomous women in both urban (AOR = 2.16, 95% CI: 1.57–2.98) and rural (AOR = 1.92, 95% CI: 1.40–2.63) areas had higher odds of screening, with the association being stronger among urban women. For CC screening, sexual autonomy was a statistically significant predictor only in urban areas (AOR = 2.06, 95% CI: 1.22–3.48); no statistically significant association was observed in rural settings. This study demonstrates rural-urban differences in the relationship between sexual autonomy and uptake of breast and cervical cancer screening services among Ghanaian women of reproductive age. The findings highlight structural inequalities in women's empowerment and access to cancer screening services. Interventions aimed at improving screening uptake should address sexual autonomy alongside location-specific barriers, particularly in rural areas where cervical cancer screening remains suboptimal. Self-reported screening data may be subject to recall bias; responses to sexual autonomy questions may also reflect social desirability. These limitations should be considered when interpreting findings.
