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Late diagnosis among patients with prostate cancer at the Uganda Cancer Institute: a retrospective cohort study
Nelson Bunani1, Angela Nakanwagi Kisakye1,2, Aloysius Ssennyonjo1
1Makerere University School of Public Health, College of Health Sciences, P.O.Box 7072, Kampala Uganda.
Background:
Late diagnosis of prostate cancer is associated with high mortality, morbidity and low quality of life. We aimed to assess the time of diagnosis among prostate cancer patients in Uganda and investigate the factors associated with early or delayed diagnosis.
Methods:
A retrospective cohort analysis of 280 records of patients with histologically confirmed diagnosis of prostate cancer from January 2016 to December 2017. Delayed diagnosis was defined as the diagnosis done at stage III or IV Stage I and II were classified as early. We used modified Poisson regression to assess factors associated with early or delayed diagnosis.
Results:
The median from symptom recognition to diagnosis was 12 months (Interquartile Range, IQR: 5-24), with 76% of patients receiving their diagnosis more than 4 months after experiencing symptoms. Notably, 35.7% of patients were diagnosed at stage III, and 46.1% at stage IV. Upon diagnosis, all patients exhibited elevated prostate-specific antgen (PSA) levels with median PSA of 100.2 ng/ml (IQR: 36.02-350) in blood.
Conclusion:
Taking a biopsy after 4 months of initial symptoms was partially responsible for the delay in diagnosis. Communities should be educated about prostate cancer symptoms and advised to seek health care early. Health care workers should be sensitized to suspect prostate cancer among patients to allow timely referral.
