Awareness, risk perception, and attitudes toward prostate cancer detection and MRI among Armenian men

Prostate cancer is a common malignancy and major cause of cancer mortality among men worldwide. Early detection improves outcomes, but participation depends on awareness, perceived risk, and attitudes toward testing and diagnostic pathways. In Armenia, many cases are diagnosed at advanced stages, partly due to limited screening practices and low public awareness. This study assessed Armenian men's knowledge of prostate cancer, perception of personal risk, and attitudes toward prostate MRI within early-detection pathways, including perceived barriers to undergoing MRI.

A cross-sectional study was conducted from December 2024 to March 2025 at the Proton Diagnostic and Educational Center in Yerevan, Armenia. The study included 196 men aged ≥45 years undergoing MRI examinations unrelated to prostate conditions. Participants completed a structured 38-item questionnaire adapted from validated international surveys assessing awareness, perceived risk, screening attitudes, and barriers to MRI screening. Four perception scores were derived from Likert-scale responses. Associations between sociodemographic factors and perception scores were examined using multivariable linear regression analysis.

The mean perceived risk score was 2.95 (SD = 0.73) and the mean awareness score was 3.21 (SD = 0.72). Men aged 56-65 years had a 0.30-point higher perceived risk than those aged 45-55 years (mean difference. = 0.30; 95% CI: 0.05-0.55). Awareness was 0.32 points lower among men with secondary education or less (mean difference = -0.32; 95% CI: -0.57 to -0.07). The mean screening confidence score was 3.45 (SD = 0.81). Perceived barriers to MRI screening were higher among men with secondary education or less (mean difference = 0.39; 95% CI: 0.18-0.60) and those with vocational or technical education (adjusted mean difference = 0.40; 95% CI: 0.19-0.61) than among those with higher education.

Awareness of prostate cancer and early detection among Armenian men moderate and varied by education level. Lower educational attainment was consistently associated with lower awareness and greater perceived barriers to MRI-based diagnostic evaluation. Targeted health education and more equitable access to diagnostic services may support earlier detection and help reduce the burden of prostate cancer in Armenia.