A study of PSA values in an unselected sample of Senegalese men

Limited data exist about prostate cancer screening in Africa. The goal of this study was to describe the distribution of prostate-specific antigen (PSA) values in an unselected population of Senegalese men being screened for prostate cancer, and to assess the role of PSA screening tests in the early detection of prostate cancer in this population.

We undertook a cross-sectional study in a community outreach setting with 113 unselected Senegalese men. Participants completed a questionnaire, underwent a digital rectal examination (DRE), and provided a blood sample for PSA testing. The questionnaire focused on demographic data, voiding problems, PSA values, and cigarette smoking. The Kruskal-Wallis test and the Fisher exact test were used to describe differences in PSA values among the groups.

The median age of the participants was 65 years (range, 36-87 years). Five percent of the men knew about PSA screening and 3% had ever been tested for PSA. The median PSA value overall was 1.28 ng/ml (range, 0.14 ng/ml-50.16 ng/ml). In the first 3 age quartiles (< 55, 55-64, and 65-72 years), the median PSA increased with age (1.0, 1.3, and 2.3 ng/mL, respectively; p = 0.012) as did the percentage of men with PSA > or = 4.0 ng/ml (4%, 7%, and 28%, respectively; p = 0.034). The percentage of men with a PSA > or = 4 ng/ml was higher in the abnormal versus normal DRE group (p = 0.023), while the median PSA was lower in the smoking versus nonsmoking group (p= 0.022). We found no relationship between PSA and occupation or ethnic group.

PSA screening is not widely used in Senegalese men. In this sample, the likelihood of having an abnormal PSA increased with age and was more common in men with abnormal DREs. These results may motivate additional studies to determine if wider use of PSA testing in this population could lead to the detection of more prostate cancer cases and improve clinical outcomes among cancer cases.