Knowledge, Attitudes, and Practices Pertaining to Prostate Cancer Among Middle-Aged and Older Men: A Cross-Sectional Study in Zibo, China

Background: This study aimed to investigate the knowledge, attitudes, and practices (KAP) related to prostate cancer (PCa) among middle-aged and older men. Methods : A multicentercross-sectional study was conducted in Zibo between February and March 2025, utilizing a self-designed questionnaire. Results : A total of 473 valid questionnaires were collected, with a mean age of 49.99 ± 3.52 years. The majority of respondents identified as Han Chinese (98.10%), were married (94.71%), were currently employed (73.78%), and reported a monthly income ranging between 5,000 and 10,000 CNY (49.05%). The scores for knowledge, attitudes, and practices were 10.57 ± 3.94 (possible range: 0-18), 31.33 ± 2.40 (possible range: 9-45), and 31.58 ± 4.55 (possible range: 8-40), respectively. Spearman correlation analysis revealed significant positive correlations between knowledge and attitudes (r = 0.151, P < 0.001), attitudes and practices (r = 0.329, P < 0.001), and knowledge and practices (r = 0.516, P < 0.001). Structural equation modeling indicated that knowledge had a direct influence on both attitudes (β = 0.528, P = 0.025) and practices (β = 0.659, P = 0.016), as well as an indirect influence on practices (β = 0.315, P = 0.008). Moreover, attitudes directly impacted practices (β = 0.598, P = 0.007). Conclusion : This study suggest that middle-aged and older men demonstrate inadequate knowledge regarding PCa, despite generally positive attitudes and suboptimal practices. These results highlight the necessity for targeted educational interventions aimed at enhancing PCa knowledge, which could subsequently improve attitudes and promote early health-seeking behaviors within this demographic. Clinical trial number: Not applicable.