Risk factors for Prostate cancer in men of African descent aged 45 years and older in Gauteng province, South Africa 2017 – 2021: Case-control study

Abstract

Background Prostate cancer (PCa) is the fifth leading cause of cancer-related deaths worldwide and the second most common cancer in men, with higher incidence among Black African men. In South Africa, PCa is a notifiable disease, yet risk factors among African men remain understudied. This study examines PCa risk factors in African men aged 45+ in Gauteng (2017–2021). Methods This study used data from the African Descent Prostate Cancer Study at Chris Hani Baragwanath Hospital, examining genetics and epidemiology in men aged 45+ (2017–2021). Data analysis in STATA 17 summarized continuous and categorical variables. Conditional logistic regression (age- matched) was preferred over Cox regression based on AIC values. Statistical significance was set at p < 0.05. Results The study analysed 2007 men aged 45 and older at Chris Hani Baragwanath Hospital (2017-2021). Among them, 1005 had prostate cancer (PCa), and 1002 served as controls. The average age was 65.5 years, with PCa patients being sufficiently older. Most participants were married (67.4%, had less than a high school education (80.5%), were retired (73.6%), and earned less than R5000 per month (94.3%). Key findings Married men had a 45% higher risk of PCa, while high school graduates had a 62% reduced risk. Employment nearly doubled the odds. Current alcohol consumers had a 59% higher risk, past drinkers twice the odds, and past smokers a 79% increase. A paternal history of PCa raised the risk 8.6 times, while diabetes reduced it by 48%. iv Conclusion Findings showed that alcohol consumption, smoking, and a family history of PCa were strong predictors. Targeted interventions should focus on raising awareness and promoting early screening, especially in hard-to-reach areas, to improve health-seeking behaviour and outcome