Unravelling prostate cancer risk and protective factors among urology patients in a Tanzanian population

Prostate cancer (PCa) is a leading cause of cancer-related morbidity and mortality among men globally. The prevalence is disproportionate among men of African descent and more specifically, in East Africa, where it is characterized by aggressive tumour biology and poor survival outcomes. Despite its high burden, the risk factors underlying its disproportionate prevalence remain understudied in this population. This study investigated lifestyle risk and protective factors among prostate cancer (PCa) patients, including demographic, dietary, lifestyle, and family cancer history, at Muhimbili National Hospital (MNH) and Ocean Road Cancer Institute (ORCI) in Dar es Salaam, Tanzania.

This case-control study compared PCa patients with non-PCa controls. Data on sociodemographic, lifestyle, diet, and family history were collected using a standardized questionnaire. Multivariate logistic regression identified significant risk and protective factors for PCa from each of these factors. Several statistical approaches were used to rank a Tanzanian urban population's significant risk or protective factors.

Ranking of broad classes of factors revealed that diet, lifestyle, sociodemographic, family, and patient history of cancer and other disease factor groups, in order of importance, were associated with PCa in men. However, the single best model explaining the odds of being PCa had intake of red meat, coffee, alcohol, tomato, and marital status as independent variables. Specifically, increased intake of red meat (AOR = 5.248), and alcohol (AOR = 2.189) were associated with a high PCa incidence while increased intake of soya (AOR = 0.248), coffee (AOR = 0.603), tomato (AOR = 0.188), and not being married (AOR = 0.147) were associated with lower incidence of PCa in the Tanzanian urban population.

The findings suggest that dietary and lifestyle factors have a significant association with PCa incidence in a Tanzanian population compared to sociodemographic, family cancer history, and exposure to infectious and other lifestyle diseases. We recommend further research, including prospective studies or randomized controlled trials with large sample sizes, to confirm these findings, as they suggest health initiatives for the prevention of PCa among high-risk populations, such as urban male populations.