PREVALENCE OF BENIGN PROSTATIC HYPERPLASIA AND PROSTATE CANCER IN AFRICANS AND AFRICANS IN THE DIASPORA
YEBOAH ED
SOURCES OF GRANT: The Ghana Study was part of Ghana Prostate Health Study (GPHS) and Case Expansion Studies 2002 – 2013 supported by National Cancer Institute/National Institute of Health (NCI/NIH) Bethesda, the University of Ghana School of Medicine and Dentistry, the Korle Bu Teaching Hospital and Government of Ghana through the Ministry of Health (MOH) Ghana.
The GPHS and Case Expansion Studies were approved by Institutional Review Boards (IRB) of NIH, NCI, University of Ghana, Ghana Health Service and Ministry of Health Ghana.
Conflict of interest: None
Background: There have been several publications on population or community prevalence of benign prostatic hyperplasia and prostate cancer from various countries and races but few reports are from Africa on Africans.
Aim: A review on the prevalence of benign prostatic hyperplasia and prostate cancer in Africans and other races.
Methodology: The current literature on prevalence of benign prostatic hyperplasia (BPH), prostate cancer (PC), and benign prostatic hyperplasia co-existing with prostate cancer in Africans and other races is reviewed.
Results: Benign prostatic hyperplasia (BPH) prevalence in Ghana is responsible for 60% acute retention of urine and 28.6% of haematuria. Worldwide prevalence of BPH varies from 20 – 62% in men over 50 years and this includes USA, UK, Japan and Ghana. Reports from South Africa indicate prevalence of over 50% in adult males of 60 years.
BPH co-existing with PC – Reports from USA, UK and Japan and Ghana reveal moderate association of BPH and PC. The co-existence of PC in patients being treated for BPH is 3 – 20%
Prostate Cancer prevalence – There is high prevalence in USA, Scandinavian Countries, African Americans (AA) and Caribbean blacks. Ghana, Trinidad & Tobago have reported high prevalence of 6 –10% in men aged 50 years and above but others reported low prevalence in Africans from Africa. The low reporting from Africa of 10 – 40:100,000 is attributable to under reporting, absence of PSA screening/testing, lack of reliable cancer registries and poor medical facilities.
Economic Costs of BPH and PC: BPH in the USA national direct costs are estimated at U$4Billion and individual costs of US$1536 annually. In Ghana, individual costs for BPH medications range from US$300 – 550 per year and cost for simple prostatectomy/TURP is estimated at US$1100. For prostate cancer, individual direct costs from Europe range from 6,575 – 12,000 euros, £2818.00 UK and over U$12,000 – 20,000 in USA per annum. In Ghana, individual direct costs ranges, for radical prostatectomy and external beam radiotherapy US$1250 – 1500, for brachytherapy 9,000 Euros, for hormonal therapy US$1600 – 3200) per year and US$510 for orchidectomy.
Conclusion: Recent evidence although sparse indicate there is high prevalence of BPH and PC in Africans and men of African descent in diaspora, the low prevalence of BPH and PC reported from some African countries is likely to under reporting and future prevalence studies both in the living and deceased are recommended to reveal the true prevalence of BPH and PC in Africans though screening for PC in the living remains controversial.
Key words:Benign prostatic hyperplasia, Prostate cancer, Prevalence, Incidence, Population, Africa, Africans, Africans in the diaspora, other races.
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