Socio-demographic characteristics, point prevalence and referral patterns of prostate cancer patients in a South African rural teaching hospital: a cross-sectional study

Résumé

Background Prostate cancer is one of the most frequently diagnosed malignancies among men worldwide and represents a growing public health concern in low-and-middle-income countries. In sub-Saharan Africa, including South Africa, the disease is often diagnosed at advanced stages due to limited screening services, delayed referrals, and structural health barriers. Understanding the socio-demographic patterns, point prevalence, and geographic origins of patients presenting with prostate cancer is critical for informing targeted cancer control interventions. Objective This study aimed to describe the socio-demographic characteristics, population point prevalence, geographic distribution, and referral patterns of patients diagnosed with prostate cancer at Nelson Mandela Academic Hospital in South Africa. Methods A quantitative cross-sectional study was conducted using secondary data from medical records of men diagnosed with prostate cancer between March 2020 and December 2021. A total of 224 patient records were reviewed. Variables collected included age, district, and sub-district residence, and referral facility. Patients were categorised into low, intermediate, and high-risk clinical groups. Descriptive statistics and chi-square tests were used to assess associations between geographic variables and disease risk. Geographic distribution was visualised using heat maps. Results The mean age of participants was 72.6 years (SD ± 8.8). Most patients (61.2%; 95% CI: 54.4%–67.6%) presented with high-risk disease at diagnosis. High-risk disease was most prevalent among patients aged 80 years and older (87.8%; 95% CI: 75.2%–95.4%). The majority of patients originated from the OR Tambo District (75.4%;95% CI: 69.3%–80.9%), particularly the King Sabata Dalindyebo sub-district, followed by Peripheral sub-districts; Amathole District (9.4%; 95% CI: 5.9%–14.0%), Chris Hani District (6.7%; 95% CI: 3.8%–10.8%), Alfred Nzo District (4.9%; 95% CI: 2.5%–8.6%), and Joe Gqabi District (3.6%; 95% CI: 1.6%–6.9 There was no statistically significant association between geographic district and risk category ( p = 0.932). Conclusion Most prostate cancer patients presenting to the teaching hospital were diagnosed with advanced disease, irrespective of geographic location. These findings highlight the need for strengthened early detection strategies, decentralised screening services, improved referral pathways, and targeted community awareness programmes in rural provinces of South Africa.

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