Full Project – Awareness of prostrate disorder and access to counselling among male adults

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CHAPTER ONE

INTRODUCTION

1.1     Background to the study

Prostate cancer is the commonest type of cancer found in men globally and is still quite difficult to understand its specific cause. Prostate cancer (or PC in short) remains a major global health issue to the public (Abdulwahab et.al, 2010). It is the most diagnosed cancer type among men and a second major cause of cancer death in men (Brawley, 2012). Generally, all men are said to be at risk for prostate cancer, however, PC is rarely found in men younger than 40 years, but have increased chances of prostate cancer after age 50 years (American Cancer Society, 2012). The lifelong risk of being diagnosed with prostate cancer reached an apex as high as 1 in 5 between 1992 and 1994. It was estimated that in 2000, PC constituted about 29% of recently diagnosed cancer types in men and about 119 of all cancer deaths, with over 31,900 men expected to die of the disease (Rubin & Williams, 2011). There is, however, little agreement among professionals on whether men should be screened or the method in which they should be treated. The effect of screening on survival is one of the most pertinent issues to resolve (Rubin & Williams, 2011).

PC is most commonly found in black Caribbean and black African men as compared to white and Asian men (Cancer Research UK, 2012). African American men possess the highest incidence level of PC globally (Kenerson, 2010). This is majorly influenced by the lack of participation in screening due to multiple cultural factors, lack of knowledge, wrong health beliefs and myths, social barriers, and relationships with their primary health care givers (Woods, Montgomery, Belliard, Johny & Colwick, 2014). From different scholarly articles and literatures reviewed, PC is asserted to be the second leading cause of death amongst men. PC is most commonly found in Southern Africa, Sub-Sahara, Western Africa and Africa as a whole and is also the major cause of male deaths in Sub-Sahara, Western Africa and Africa generally (Globocan, 2013; cited in American cancer society, 2011). The rate of incidence in Southern part of Africa is double the second highest rate in Western Africa and almost seven times greater than the least regional rate in North Africa. In Nigeria, it is also the most common male cancer diagnosis and may be considered as high as in African Americans in the United State (Globocan, 2009; cited in the American cancer society, 2011). In most developing nations such as Benin Republic, Gambia, Senegal, Ghana, and Nigeria, easy access to healthcare and prostate cancer screening methods for early detection is inadequate (Odedina, 2012). High mortality rate has been revealed to be caused by late detection (Woods et.al, 2014). Screening is the commonest method for early detection of all cancer types in asymptomatic populations. The main problem associated with early detection in prostate cancer prevention among men is the lack of knowledge about screening, counseling and poor detection methods among medical experts (Woods et.al, 2014).

Also, the belief systems and awareness regarding prostate cancer screening among men is very important for the early detection and control of the condition. In African men, lack of proper discussion about decision to proceed with screening and lack of effective cultural communication with health providers and experts has created a level of fear and distrust amongst them. It has also contributed to the high probability of men not participating in prostate cancer screening (Woods et.al, 2014). Screening is identified as the most common strategy used for early detection of cancer at its asymptomatic stage (Woods et.al, 2014). The main purpose of screening, therefore, is to lower the chances of developing the disease at the asymptomatic stage thereby curbing the mortality and morbidity rate of prostate cancer among men. It has also been discovered that patients in Sub-Saharan Africa are presently with the locally advanced disease as a result of inadequate screening program, limited diagnostic facilities, lack of health education, inadequate skilled health expert, and sheer ignorance (Ajape, Babata & Abiola, 2010). In accordance with Woods et.al, (2014), past negative experiences, inadequate health insurance, lack of knowledge, traditional myths and attitudes about male roles, fear of prognosis and diagnosis, fear and distrust in medical community due to information gap, health experts and providers attitude, cultural and religious beliefs, superstitions and attitudes also contribute to the non-participation in prostate cancer screening and necessary counseling (Woods et.al, 2014).

1.2     Statement of problem

Although higher awareness levels on prostate cancer have previously been reported among Nigerian men aged 50 years and above, their awareness levels on prostate cancer (that is, the symptoms, signs, detections, treatment, prevention and outcomes) were low (which implied less than 40%) (Oladimeji, Bidemi, Olufisayo, & Sola, 2010).  Similarly, studies in Senegal also show low levels of knowledge regarding prostate cancer (Gueye et al., 2013; Punga-Maole, Moningo, Kayembe, Tshikuela, & Kabongo, 2013).  Although early detection is a crucial component of a successful prostate cancer therapy, a majority (87.5%) of the patients in are present with the advanced stage of the disease due to low awareness and lack of early screening and detection services (Magoha & Ngumi, 2010; MPHS & MMS, 2011; Wasike & Magoha, 2017).

More so, researchers discovered that sexual dysfunction is a very sensitive issue for African men, therefore serving as a deterrent from participating in prostate cancer screening and early detection strategies (Woods et.al, 2014). It is stated that if screening will greatly benefit men in quality of life enhancement, men should begin screening if at family risk of prostate cancer and also should be based on decision in men of more advanced ages (American Urology Association, 2013). For effective screening to be achieved in Africa, especially in the Nigerian society, it is pertinent to have an idea of health knowledge, awareness of prostrate disorders and symptoms, beliefs and attitudes towards screening of this disease among men (Ajape, Babata & Abiola, 2010). It is against this backdrop that the study sought to determine awareness of prostrate disorder and access to counseling among male adults in Federal Medical Centre (FMC), Owerri, Imo State.                                                               

1.3     Objectives of the study

The general objective of this study is to determine the level of awareness of prostrate disorder and access to counseling among male adults in Madonna University Teaching Hospital, Rivers State. However, the specific objectives are as follows;

1. To determine if men in MUTH have knowledge about prostate cancer disorder
2. To determine if counseling and screening is done for prostate cancer among men in MUTH
3. To examine the associations of levels of awareness and knowledge towards prostate cancer with socio-demographic variables and adherence of prostate cancer screening among men in MUTH

1.4     Research questions

The following questions guided the research in order to achieve the objectives of the study.

1. Do men in MUTH have knowledge about prostate cancer?
2. Are men in MUTH exposed to prostate cancer screening/counseling services?
3. Is there any relationship between their knowledge of prostate cancer and socio-demographic variables?
4. What are the risk factors that predispose the development of prostate cancer among men in MUTH?

1.5     Significance of the study

This study will be of benefit to students, adult males, society, health workers and future researchers.

Students: the students stand to benefit from the findings of this study, as it will provide adequate information on the disease condition as well as behaviours towards health promotion in individuals.

Adult Males: this study will provide information on the concept of prostate cancer and disorders. It will encourage changes in behaviour towards avoiding risks for the development of prostate cancer among men

Society: this study will serve as a baseline study for the area, as paucity of information was encountered in the cause of this work. Individuals and families can be guided with regards to healthy behavior, encouragement for uptake of counseling and eliminating the barriers involved.

Health Workers: based on the findings f this study, health workers will be encouraged to provide strategic health measures which are aimed at promoting proper and detailed knowledge on prostate cancer and make counseling easier and more accessible and easier.

Future Researchers: information gathered from this study will serve as a source of literature and guide for future research and as well serve as empirical reference for further studies.

1.6     Scope of study

The main focus of this study is to assess the level of awareness of prostrate disorder and access to counseling among male adults in Madonna University Teaching Hospital, Rivers State. The scope of the population used is men that attend and receive health care at Madonna University Teaching Hospital, Rivers State. This would provide a basis for scientific based inference and decision making.  

1.7     Operational definition of terms

Awareness is the state or condition of being privy to basic information of prostate cancer (i.e., ever heard of prostate cancer).

Knowledge is simply defined as having information on prostate cancer. The information includes; what the signs and symptoms are, and treatment and prevention modalities for prostate cancer among others.

Prostate cancer is defined as a cancer that affects the male prostate gland. Uptake of prostate cancer screening refers to being tested for prostate cancer by any of the common screening methods which include; direct rectal examination, prostate specific antigen and biopsy etc.

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Full Project – Awareness of prostrate disorder and access to counselling among male adults