The Impact of Prostate Specific Antigen Testing on Incidence of Prostate Cancer cases in Zimbabwe

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DOI: 10.21522/TIJCR.2014.04.02.Art006

Authors : Assam Musonza, Lynn Zijenah, Victor T. Nyanhete


Prostate cancer is the leading cancer causing death in Zimbabwean men according to the Zimbabwe National Cancer Registry. By 2004 prostate cancer had become the most common cancer in Zimbabwean men. The incidence of prostate cancer shows strong age, race and geographical dependence. The prostate specific antigen (PSA) is a serine protease produced by cells of the prostate gland. The PSA blood test measures the level of PSA in man’s blood and is used as a biomarker for prostate cancer (PCa). Unfortunately the PSA is prostate specific but not PCa specific. PSA testing started in Zimbabwe in 1995. The specific objectives of the study were: (i) to determine the age range most affected by PCa, (ii) to evaluate the impact of PSA testing on PCa cases in Zimbabwe. The study was a retrospective cross sectional study. Secondary data of all histology confirmed cases of PCa were obtained from the Zimbabwe National Cancer Registry (ZNCR) and analysed. Graph Pad Prism 7.03 was used to statistically analyse the data. The two-tailed T-test was employed to compare the number of pre-PSA cases against the number of post PSA era cases. 5277 PCa cases covering a thirty year period were retrieved. The first ten years (1986-1995) were the pre PSA era period and the next twenty years (1996-2015) were the post PSA era. The median age was 71 (IQR 64-78) years. There was a significant difference between number of PCa cases of the pre-PSA era (1986-1995) and the first post PSA era 1996-2005, and the second PSA era (2006-2015) (p =0.0042 and p=0.0028 respectively. This showed the impact that PSA testing had on PCa in Zimbabwe (2006- 2015). The study showed that the age group most affected by PCa was the 64-78 years. .

Keywords: Prostate cancer, Cross Sectional Study, Prostate Specific Antigen, PSA impact, age group, Zimbabwe.


[1]. Andriole, G., Bostwick, D., Brawley, O., Gomella, L., Marberger, M. Tindall, D ….. (2004) Chemoprevention of Prostate Cancer in men at high risk: rational and design of the reduction by dutasteride of prostate cancer events (REDUCE) trial. J Urol: 172 (4PT1): 1314 - 7

[2]. American Cancer Society (2009-2010). Cancer facts and figures for African-Americans (2009-2010). American Cancer Society. Atlanta.GA (2009).

[3]. Babb, C., Urban, M., Kielkowsk, D., and Kellett, P. (2014). Prostate Cancer in South Africa: Pathology Based National Cancer Registry data (1986-2006) and Mortality rates (1997—2009). Prostate Cancer. Volume 2014, Article ID 419801.

[4]. Boyle, P., & Levin, B. (2008). World Cancer Report 2008. Lyon France: World Health Organisation, International Agency for Research on Cancer.

[5]. Bratt, O., Kristofferson, U., Lundgren, R., Olsson, H., (1999). Familial and hereditary prostate cancer in southern Sweden. A population based case study. Eur J Cancer: 35 (2); 272 – 7.

[6]. Bubendorf, L., Schöpfer, A., Wagner, U., Sauter, G., Moch, H., Willi, N., … Mihatsch, M. J. (2000). Metastatic patterns of prostate cancer: An autopsy study of 1,589 patients. Human Pathology, 31(5), 578–583.

[7]. Caplan, A., Kartz. A. (2002). Prostate - specific antigen and the early diagnosis of Prostate Cancer. American Journal of Clinical Pathology. 117 (Supl: S104- 108).

[8]. Center, M. M., Jemal, A., Lortet-Tieulent, J., Ward, E., Ferlay, J., Brawley, O et al (2012). International variation in prostate cancer incidence and mortality rates. Eur Urol, 61. 1079-1092.

[9]. Guzzo, T.J Drach, G. W, Wein, A. J., (2016) Primer of Geriatric Urology.

[10].  Groomberg, H., Wiklund, F., Damber, J. E., (1999). Age specific risks of familial prostate carcinoma; a basis for screening recommendation in high risk populations. Cancer. 86 (3): 477 – 83.

[11].  Heijnsdijk, E.A.M., Wever, E.M., Auvinen, A., Hugosson, J., Ciatto, S., Nelen, V., 2012). Quality – of – Life Effects of Prostate- Specific- Antigen Screening. N Engl J Med; 367: 595 – 605.

[12].  Hsing, A.W., Devesa, S.S., (2001). Trends and Patterns of Prostate Cancer: What do they suggest? Epidemiol Rev; 23 (1): 3- 13.

[13].  Isaacs, W., & Kainu, T. (2001). Oncogenes and tumour suppressor genes in prostate cancer. Epidemiol. Rev, Volume 23, pp 36-41.

[14].  Jemal, A., Bray, F., Forman, D., O’Brien, M., Ferlay, J., Center, M., & Parkin, M. (2012). Cancer Burden in Africa and Opportunities for Prevention. Cancer. DOI; 10. 1002/cncr. 27410, Received August 10 2011; Revised: October 24, 2011, published online in Wiley Online Library (

[15].  Moyer, V, A., (2012). US. Preventive Services Task Force. Screening for prostate cancer: US. Preventive Services Task Force recommendation statement. Ann Intern Med. 157; 120-34.

[16].  Neal, D. ., Neal, C. information about the author D. ., & Neal, Email the author D.E, H.Y Leung, P.H Powell, F.C Hamdy, J. D. (2000). Unanswered questions in screening for prostate cancer Neal 2000 - European Journal of Cancer. (00)00104-0.

[17].  Sakr, W. A., Haas, G. P., Cassin, B.F., Pontes, J. E., Crissman, J.D. (1993). The frequency of carcinoma and intraepithelial neoplasia of the prostrate in young patients. J. Urol: 150(2) Pt 1: 379- 385.

[18].  Salinas, C. A., Tsodikov, A., Ishak-Howard, M., & Cooney, K. A. (2014). Prostate cancer in young men: an important clinical entity. Nature Reviews. Urology.

[19].  Soos, G., Taskiris, I., Szanto, J., Turzo, C., Haas, P. G., and Dezso, B. (2005). The prevalence of prostate carcinoma and its precursor in Hungary; an autopsy study. Eur Urol: 48 (5): 739 – 44.

[20].  The National board of health and welfare. Cancer Prevalence Riket. (2008).

[21].  Whitmore, W. F. (1994). Localised prostatic cancer: Management and detection issues. Lancet.

[22].  Zimbabwe National Cancer Registry Report (2014).