Trends, Geospatial Distribution, Features and Determinants of Prostate Cancer Disease in Ghana – A Twelve-Year Retrospective Analysis of Hospital Data

Background: Despite the globally acknowledged elevated prostate cancer risk among men of African descent, limited data exist on how incidence, severity, and outcomes differ across Ghana’s ethnic and demographic groups. This study investigates clustering patterns, risk profiles, stage at diagnosis, and treatment outcomes among patients at Sweden Ghana Medical Center in Accra. By examining PSA levels alongside physical and socio-demographic factors, the research aims to improve local detection and management and help in efforts to address the rising prostate cancer burden. Objective: This study investigates the trends, geospatial distribution, demographic/physical determinants, disease characteristics, and treatment outcomes of prostate cancer patients at the Sweden Ghana Medical Centre (SGMC) to provide insights into the Ghanaian context. Methods: An analysis of retrospective data from 852 prostate cancer patients who visited SGMC from 2011 to 2023 was conducted. Demographic information, disease characteristics (clinical stage, risk stratification, and PSA levels) and treatment outcomes (PSA response and incidence of toxicity) were studied. Results: Study participants were all males, mostly aged ≥55 years (75%), with a modal age of 65–74 years (44.6%). For prostate cancer (PCa) patients, 55.52% were Akan, and 14.91% Ewe, 13.38% were Ga, 7.63% were northern Ghanaian Ethnicities. Most had high PSA levels and BMI >24.5 kg/m² (79.48%), with 59.3% classified as overweight. Urban dwellers predominated (74.79%). Metastasis rate was 28.7%, late disease rate was 46.8%, high risk localized disease rate was 44.8%, and treatment success/response rate was 22.8% (for sustained PSA drop-to-Nadir/drop to ≤ 0.5ng/ml) or 53.8% (for 50%-PSA drop). Disease trends were rising; with a 10% PCa registration rate over the 12-year period. Majority of PCa patients were married (70.6%; OR = 1.73, p < 0.001), of high socioeconomic status (59.3%; OR = 1.59–3.30, p < 0.001), were of professional occupations (40.38%) or retirees (21.60%), and were Sedentary (56.5%; OR = 0.89, p < 0.039). PSA distributions showed a median ≥29 ng/ml (explaining over 50% of cases) and a Q3 PSA of ≥12.9 ng/ml (explaining at least 75%). PCa was associated with Age >65, OR = 2.12–2.51 (p < 0.001); weight-to-height ratio (OR = 1.23, p = 0.0022); PSA (OR = 1.02, p < 0.001); a positive family history (OR = 2.18–4.49, p < 0.001), Ethnicity, OR = 0.799 (p < 0.001) compared to Akan, Body Weight, (OR = 1.008/kg (p = 0.026). Alcohol (31.3%; OR = 0.81, p = 0.042) and tobacco use (8.6%; OR = 0.37, p < 0.01) were weakly linked. Comorbidities were rare, with hypertension (10.55%) most frequent. BMI correlated directly with high-risk localized PCa, but inversely with metastasis. Ga and Ewe ethnicities had lower odds of high-risk DRE disease than Akan (OR = 0.52, p = 0.049). Conclusions: Though limited by secondary data, Age, elevated PSA, family history, linear-weight-to-height ratio, Ethnicity, marital status, sedentary occupation, and high socio-economic status were identified as key determinants of prostate cancer. Late presentation and poor outcomes were rife. Aggressive measures on all fronts are needed to prevent, and diagnose more early-stage prostate cancer, nationally, to improve prostate cancer outcomes.