Knowledge, beliefs and intentions of African men in the Free State about prostate cancer screening

Background: African men are less likely to participate in prostate cancer (PCa) screening, which may be beneficial to some of them. Gaps in knowledge, cultural factors and beliefs are associated with their screening intentions. Aim: To determine the knowledge, cultural factors and screening intentions of African males regarding PCa screening. Setting: The study was conducted among African men attending randomly selected primary healthcare clinics in the Free State province. Methods: An analytical, cross-sectional survey using self-administered questionnaires developed in line with the Theory of Planned Behaviour constructs. Results: Of the 389 respondents, 18.3% had ever been screened for PCa with prostate-specific antigen (PSA) testing and 6.2% by digital rectal examination (DRE). About a quarter (24.4%) of the respondents had knowledge scores >= 50%. Factors associated with greater intent to screen for PCa were lower degree of fear/apprehension of PCa screening (mean score = 2.03; p < 0.001), higher perceived benefits of PCa screening (mean score = 2.69; p = 0.002), lower perceived situational barriers to PCa screening (mean score = 2.03; p = 0.006) and higher perceived risk of getting PCa (mean score = 2.66; p = 0.024). Conclusion: The observed low level of knowledge and practice of PCa screening among the respondents could be enhanced through PCa awareness strategies targeted at these men or those that could influence their decision making, especially healthcare providers. Factors that enhance screening intentions should be promoted. Contribution: This study improves on the scarce literature on factors associated with African men's PCa screening intention.