Prostate cancer clinicopathological presentation in South-East Africa during the 2010 decade

Prostate cancer is the leading cause of cancer-associated death among men across Sub-Saharan Africa, with Southern and East Africa ranking first and fifth globally. However, lack of coordinated national cancer registries has biased data toward single-sourced, averaged, or model estimates. Here, our retrospective study included 8634 South-East African patients diagnosed between 2010 and 2019, which when compared with 71 694 Black and 322 356 White period-matched American men, were over threefold more likely to present with aggressive disease (International Society of Urological Pathology grade groups ≥4: 45.38% vs 21.22% and 21.05%; prostate-specific antigen ≥20 ng/mL: 62.04% vs 17.29% and 11.17%, respectively; all 2-sided P < .0001). East over Southern African men are 1.5 times more likely to present with advanced disease, however, age was not a confounder. Supporting prostate cancer as a major health concern for Africa, our data suggest underestimation in East Africa, while highlighting the need for accurate monitoring, increased awareness, and tailored screening criteria.