Clinicopathological Profile of Prostate Cancer Patients at a Tertiary Hospital in the Eastern Cape, South Africa

Abstract

Background: Prostate cancer remains a major cause of cancer-related morbidity and mortality among men worldwide. Limited access to oncology services contributes to late presentation, delayed diagnosis, and treatment. This study describes the clinicopathological profile of prostate cancer and identifies factors associated with disease severity at presentation in an Eastern Cape population. Methods: A retrospective cross-sectional study was conducted among men diagnosed with prostate cancer at a tertiary hospital between 2014 and 2024. Demographic, clinical, and pathological data were extracted. Descriptive analyses were performed, and multivariable logistic regression was used to identify independent predictors of advanced disease. Results: The study included 202 patients with a mean age of 67.2 years. Thirty-four (16.8%) reported a family history of prostate cancer, and 62.4% had never undergone PSA screening before diagnosis. Elevated PSA levels were common (60.4%), and more than half of patients presented with advanced disease (54.5%). High-risk and very high-risk disease were identified in 44.1% and 21.3% of patients, respectively. Lack of prior PSA screening was independently associated with high-risk disease (aOR 2.4, 95% CI 1.1–5.0), advanced stage at presentation (aOR 2.4, 95% CI 1.2–4.8), and PSA > 20 ng/mL. Conclusions: There is a high burden of late-stage, high-risk prostate cancer at presentation. These findings highlight ongoing challenges in early detection and emphasize the need for improved awareness, screening, and referral pathways to improve outcomes.