Factors associated with late diagnosis of prostate cancer in Togo, Sub-Saharan Africa

Background : Prostate cancer represents a real public health issue in countries with limited resources and is often diagnosed at late stages. The aim of the study was to determine the factors associated with late diagnosis of prostate cancer in Togo. Methods : This was a cross-sectional study with a descriptive and analytical, relating to cases of prostate cancer, diagnosed in the Urology department and histologically confirmed at the Pathological Anatomy and Cytology Laboratory of the Lomé; from April 4, 2022 to April 28, 2023, in Togo. Results : A total, 102 cases of prostate cancer were recorded. The average age was 67.79 ± 8.5 years. The mean PSA level was 521.3933±1060 ng/ml. Histologically, it was acinar adenocarcinoma in 99.02%. All patients in our study were diagnosed at the late stage with 31.37% pT3NxMx stage and 68.63% pT4NxMx stage of the pTNM classification. It was Gleason score 9 in 31 patients (30.39%). After multivariate analysis, two factors were associated with late diagnosis of prostate cancer : diagnostic error (p-value = 0.032; ORC = 1.30; 95% CI [1.10-24.9]); taking a second opinion (p-value = 0.0170; ORa = 2.62; 95% CI [2.01-4.7]). However, factors involving easy access to the health system before prostate cancer diagnosis appear to be major protective factors for diagnosis at an advanced stage of disease. Conclusion : The diagnosis error and the taking of a second opinion are the factors on which it will be necessary to act to make an early diagnosis of prostate cancer in our context.