Reported by Ariajegbe Sylvia Esezobor
Prostate cancer is the most commonly diagnosed cancer among Nigerian men and one of the leading causes of cancer-related deaths, yet the vast majority of cases are detected only after the disease has progressed beyond curative stages, a pattern that oncologists and urologists say can be reversed with early screening and greater public awareness. Data from specialist clinics show that over 80 per cent of Nigerian patients present with advanced prostate cancer, significantly higher than rates in developed countries where early detection is more common. In London, only 12.5 per cent of men present with incurable prostate cancer, compared with Nigeria, where more than 80 per cent of cases are already beyond cure. The contrast is not a matter of genetics or biology, but of awareness, access and the cultural and structural barriers that keep Nigerian men from seeking screening until symptoms become impossible to ignore.
Prostate cancer is a disease of the prostate gland, a small organ below the bladder that produces seminal fluid. It is the second most common cancer in men globally and the most common cancer among Nigerian men, accounting for over 11 per cent of all male cancer deaths in the country. Nigeria records an estimated 125,000 to 128,000 new cancer cases annually and approximately 72,000 to 80,000 cancer deaths, with prostate cancer leading among men and accounting for 14 per cent of the national cancer burden. The incidence rate of prostate cancer in Nigeria is 32.8 per 100,000, while the mortality rate is 16.3 per 100,000. Approximately one in every four to six men may develop prostate cancer in their lifetime, and the risk increases with age, particularly after 50. Men of African descent face elevated risk, making early and regular monitoring essential.
The reasons for late presentation are deeply rooted in Nigerian society. Cultural misconceptions often frame prostate cancer as a spiritual affliction or an incurable condition, discouraging early detection. Masculinity norms portray screening as a sign of vulnerability, and many men rely on traditional medicine rather than biomedical screening. Structural barriers, including the cost of screening, distance to health facilities and the stigma associated with a cancer diagnosis, compound the problem. A community-based study in Ilesa West, Osun State, found that among 81 men aged 40 and above, only 2.5 per cent had ever undergone prostate-specific antigen testing, while just 11.1 per cent were aware of prostate cancer. The study also found that elevated PSA levels were present in 21 per cent of participants, and that lower urinary tract symptoms were significantly associated with elevated PSA levels. These findings underscore the scale of the awareness and screening gap in Nigeria.
The symptoms of prostate cancer are often silent in the early stages, which is precisely why screening is critical. Some patients may notice frequent urination or a weak urinary stream, but these symptoms can also be caused by benign prostatic hyperplasia, a non-cancerous enlargement of the prostate that becomes increasingly common as men age. By the time more alarming symptoms appear, such as blood in the urine, bone pain or difficulty urinating, the cancer may have already spread. Prostate cancer is highly treatable when detected early, with a five-year survival rate for localized prostate cancer exceeding 98 per cent. When caught late, it becomes a different disease entirely, one that is difficult to treat, expensive to manage and often fatal.
The screening tools are simple and widely available. The primary screening method is the Prostate-Specific Antigen blood test, which measures the level of a protein produced by the prostate. A digital rectal examination, in which a doctor inserts a gloved finger into the rectum to feel the prostate gland, is also used to detect abnormalities. Medical experts recommend that screening should generally commence at age 50, but men with a family history of prostate cancer or of African ancestry are advised to begin screening earlier, from age 45. Some experts have suggested that men above 40 should undergo annual screening, particularly those with risk factors. The Nigerian National Cancer Control Plan 2018-2022 previously recommended implementing digital rectal examination and PSA testing for men at all levels of healthcare, though routine PSA screening is not supported by international evidence due to the risk of overdiagnosis and uncertain impact on mortality. The current emphasis is on early diagnosis rather than population-wide screening.
The Federal Government has taken steps to address the burden. In February 2026, the government launched a nationwide free cancer screening programme covering 6,000 asymptomatic Nigerians across the six geopolitical zones, focusing on breast, cervical and prostate cancers. The National Cancer Health Fund provides free treatment for breast, cervical and prostate cancers at designated centres of excellence across the country. The Nigerian Health Insurance Authority has expanded radiotherapy access and approved tariffs of one million naira for prostate cancer treatment. A global health award from the Hästens-Prostate Cancer Foundation is supporting the expansion of prostate cancer care in Nigeria, with a focus on increasing awareness, early detection and generating high-quality data to inform improvements in care. Specialist facilities are also expanding capacity, with The Prostate Clinic in Lagos performing over 100 robotic-assisted prostate cancer surgeries within its first year of operation.
For Nigerian men, the message from the experts is unambiguous. Prostate cancer is not a death sentence when detected early. The barriers are real, but they can be overcome. Screening is available, effective and increasingly affordable. The consequences of delay are severe, not only for the men who suffer but for their families and communities. As one survivor put it, timely diagnosis and access to modern treatment made a significant difference in his outcome. The question is no longer whether Nigerian men should screen, but when, and the answer from every credible source is the same: now.
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