Blue November: Against prostate cancer

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Extract from the article: Prostate cancer is one of the most common cancers in men. Its actual incidence varies greatly from region to region: while diagnoses are increasing everywhere due to ageing populations and improved screening, mortality remains particularly high....

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Prostate cancer is one of the most common cancers in men. Its actual incidence varies greatly from region to region: while diagnoses are increasing everywhere due to ageing populations and improved screening, mortality remains particularly high where access to early screening, diagnostic care and quality treatment is limited.

Estimates from the International Agency for Research on Cancer (IARC) indicate that millions of men were diagnosed with cancer in 2022 and that long-term trends predict a sharp increase in new cases in the coming decades.

According to the medical journal The Lancet and the study Global, regional, and national burden of prostate cancer, 1990–2040, the annual number of prostate cancer cases could rise from 1.4 million in 2020 to 2.9 million in 2040.

Prostate cancer consistently ranks among the most commonly diagnosed cancers in men worldwide; incidence rates are highest in high-income countries, partly due to more widespread screening (PSA) and better case registration. Recently published projections suggest that the number of cases diagnosed each year could almost double by 2040 if nothing is done to improve prevention, early diagnosis and access to treatment.

Situation in Africa: high burden and late diagnosis

In Africa, prostate cancer is one of the most common cancers in men and is among the leading causes of cancer death in men in several countries. A study conducted by the World Bank and the World Health Organisation (WHO) reveals that cancer is on the rise in Africa, with approximately 1.1 million new cases recorded in 2020, including 16.8% of breast cancer cases and 10.6% of cervical cancer cases. Prostate cancer is more common in men, accounting for 8.7% of cases, followed by liver cancer at 6.2%.

Mortality rates are often higher than elsewhere because cancers are diagnosed at advanced stages, opportunities for specialised care (urology, radiotherapy, chemotherapy, hormone therapy) are limited, and information and screening systems are inadequate.

Recent studies and analyses show increases in incidence and mortality in several African countries and call for appropriate strategies for awareness-raising, targeted screening and clinical capacity building.

The situation in Togo: what the data says

Available data (IARC/GLOBOCAN and national databases) indicate that, in Togo, prostate cancer is one of the leading causes of cancer mortality in men. In a 2022 interview with Santé-Éducation, Prof Kodjo Michel Tengue, Head of Urology, stated that  each year , around 300 new cases of prostate cancer are recorded at the Sylvanus Olympio University Hospital in Lomé .

Cancer mortality in men often places prostate cancer at the top of the list, reflecting late diagnosis and limited access to specialised treatment. The absolute figures remain lower than in larger regions, but the proportion of deaths related to prostate cancer compared to other male cancers is worrying.

Risk factors and epidemiological characteristics

Recognised risk factors include age (risk increases after 50), ethnicity (men of African descent often develop more aggressive forms), family history, and possibly lifestyle factors (obesity, diet). In Africa, over-diagnosis is less of a problem than under-detection: many cancers remain asymptomatic until an advanced stage.

Blue November / Movember

Blue November (or Movember) is a global campaign to raise awareness of male cancers, particularly prostate and testicular cancer, and men's mental health, marked by the blue ribbon and communication initiatives in November. Launched in the early 2000s, the campaign aims to raise awareness of signs and symptoms, promote targeted screening, raise funds for research and support services, and combat the stigma that prevents men from seeking medical advice.

Evaluations show that these campaigns increase the visibility of the issue and can increase demand for screening and information, but their real impact on reducing mortality depends on the availability of appropriate diagnostic pathways and treatments after detection. In other words, awareness is necessary but must be accompanied by a strengthening of healthcare provision.

Movember, or ‘Blue November,’ responds to a real need for awareness and destigmatisation among men. Its maximum effectiveness is achieved when campaigns are linked to concrete services (targeted screening, access to diagnosis, active case management).

Raymond DZAKPATA (Sources: IARC/GLOBOCAN, prostate fact sheet & Global cancer statistics 2022)