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Prevention and Detection of Prostate Cancer: A Pilot Intervention in a Resource-Poor South African Community

Matshela, Ramogomo Frans BCur; Maree, Johanna E. DCur; Belkum, Corrien van PhD (Didactics)

doi: 10.1097/NCC.0b013e31829194d2

Background: Prostate cancer is a global health problem strongly linked to the Western lifestyle and its health risks. South Africa, like many African countries, has no population-based screening for this disease.

Objective: The purpose of this study was to develop and pilot test an intervention focused on the prevention and detection of prostate cancer in a resource-poor community in Tshwane, South Africa.

Intervention: Personal invitations for screening were extended to 122 men 40 years or older. Those presenting for screening received health education on prostate cancer and were screened using digital rectal examination and a prostate-specific antigen (PSA) test. Follow-up appointments were also arranged.

Results: Only 53.3% (n = 65) of the invitees reported for screening, with 38 (58.5%) returning to the clinic to learn the results of the PSA test. Knowledge of prostate cancer improved significantly after the intervention. Abnormal findings were detected in 6.2% (n = 4) of the participants, and elevations in PSA levels, in 12.3% (n = 8).

Conclusions: Disappointing results in terms of screening uptake and the number of men lost to follow-up were achieved. The strategies to improve knowledge were successful and resulted in a significant increase in knowledge of prostate cancer.

Implications for Nursing Practice: The success of a cancer prevention and detection service is determined by participation and screening uptake. The reasons for not accepting the screening invitation and not returning to learn the findings of the PSA test should be explored. Preventative strategies should be developed and tested as part of a second pilot study testing the refined intervention.

Author affiliations: Adelaide Tambo School of Nursing Science, Tshwane University of Technology, Pretoria (Mr Matshela and Dr van Belkum); Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa (Dr Maree).

This study was approved by the ethics committee of the Tshwane University of Technology as well as the manager of the initiative rendering healthcare services to the specific community.

The Atlantic Philanthropies, through the University-Based Nursing Education South Africa program, made this study possible.

The authors have no conflict of interest to disclose.

Correspondence: Johanna E Maree, DCur, Department of Nursing Education, University of the Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa (

Accepted for publication March 9, 2013.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins