Prostate cancer screening: Knowledge, attitudes and practices in a sample of men in Ramotswa, Botswana.

Background: Prostate cancer (PCa) accounts for 21.6% of all cancers among men in Botswana, ranking as the fourth most common cancer (9%) across all age groups. This study aimed to assess the knowledge, attitudes and practices related to PCa screening among men aged 40 years and older in Ramotswa, Botswana. Design and methods: A cross-sectional survey was conducted involving a random sample of 362 males aged 40 years and older in Ramotswa. Logistics regression models were utilised to examine associations between socio-demographics, knowledge, attitudes, practices and PCa screening. Results: Of the 362 respondents, 105 (29%) men reported having undergone prostate screening tests either prostate-specific antigen (PSA) or digital rectal examination (DRE). Additionally, 221 (61%) had prior knowledge of PCa, with 114 (32%) receiving information from the radio while fewer than 20% learnt about it from health care providers. Single men were found to be 63% less likely to go for screening compared to married men (AOR = 0.37; [95% CI 0.22-0.61]). Men who were not afraid of the screening test results were twice as likely to go for screening compared to those who were afraid of a positive result for prostate test (AOR = 2.14; [95% CI 1.12-4.09]). Conclusions: While respondents demonstrated above-average knowledge of PCa, fewer than half had undergone a PSA test. Urgent and targeted interventions are needed to address predisposing factors such as fear of prostate screening. Furthermore, the low rates of PCa information dissemination by healthcare workers underscore the need for enhanced engagement of medical practitioners in educating men about PCa.