Systematic review of prostate cancer screening in Sub-Saharan Arica

Mohamed Jalloh^1,#,*, Louise Makau-Barasa^2,#, Joana Ainuson-Quampah³, Ada Okechukwu⁴, Lamine Niang¹, Oseremen Aisuodionoe-Shadrach⁵, Serigne Gueye¹, Akin Adebiyi⁶, Ben Adusei⁷, Pedro Fernandez⁸, Abraham van Wyk⁸, Olufemi Ogunbiyi⁹, James E. Mensah¹⁰, Caroline Andrews¹¹, Ilir Agalliu¹², Thomas Rohan¹³, Ann Hsing¹⁴, Timothy R. Rebbeck¹¹
1 Service d’Urologie, Hopital General Idrissa Pouye, Dakar, Senegal
2 Dana-Farber Cancer Institute, Harvard University, 450 Brookline Avenue, Boston, MA, USA
3 School of Biomedical and Allied Health Science, College of Health Sciences, University of Ghana, Accra, Ghana
4 Department of Public Health Sciences, West Chester University, 700 South High Street, West Chester, PA, USA
5 Division of Urology, Department of Surgery, College of Health Sciences, University of Abuja, Abuja, FCT, Nigeria
6 Department of Epidemiology, College of Medicine, University College Hospital, University of Ibadan, Ibadan, GPO, Nigeria
7 Department of Urology, 37 Military Hospital, Liberation Road, Burma Camp, Accra, Ghana
8 Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
9 Department of Pathology, College of Medicine, University College Hospital, University of Ibadan, Ibadan, GPO, Nigeria
10 Korle-Bu Teaching Hospital and University of Ghana Medical School, Guggisberg Venue, Accra, Ghana
11 Division of Population Sciences, Dana-Farber Cancer Institute, 450 Brookline Ave, 1101 Dana, Boston, MA, USA
12 Department of Epidemiology and Population Health, Department of Urology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
13 Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
14 Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
* Corresponding Author: Mohamed Jalloh. Email: email , email
#Denotes equal contributions
(This article belongs to the Special Issue: Advancing Early Detection of Prostate Cancer: Innovations, Challenges, and Future Directions)

Canadian Journal of Urology https://doi.org/10.32604/cju.2026.077318

Received 06 December 2025; Accepted 25 May 2026; Published online 29 June 2026

Abstract

Backgrounds: Prostate cancer (PCa) in Sub-Saharan Africa (SSA) is characterized by late-stage diagnoses and high mortality. PCa screening is uncommon. This review presents current evidence on PCa screening practices across SSA to identify prevailing trends, methodological limitations, and opportunities for early detection. Methods: A systematic literature review identified seven studies conducted in SSA over the past three decades, focusing on PCa screening modalities, population characteristics, geographical distribution, and outcomes. Studies were identified from PubMed, Embase, Web of Science, African Index Medicus, and Global Health and uploaded into Covidence for screening, sorting and data extraction. The search period was limited to June 2022 and prior. Keywords combination were designed to target studies on screening, prostate cancer diagnosis and outcome and Sub Saharan Africa. Results: All studies were institution-based and predominantly conducted in urban settings, with no standardized screening protocols or mortality endpoints reported. Prostate-specific antigen (PSA), digital rectal examination (DRE), and transrectal ultrasound (TRUS) were the primary screening tools used; however, no study assessed sensitivity, specificity, or predictive values. Considerable variation was observed in PSA assay types, cut-off thresholds, and age ranges, limiting comparability. None of the studies incorporated MRI or evaluated screening performance by age group. The absence of national-level studies and harmonized guidelines highlights a critical gap in current research and practice. Conclusion: There is an urgent need for representative, population-based studies in SSA to inform optimal early detection protocols, understand clinical outcomes, and address geographic and demographic disparities. Available data limits the development of PCa screening guidelines in SSA. To address this shortcoming more studies will be required to develop responsive risk-adapted strategies that would work in resource limited settings and support early detection of PCa cancer in SSA.