Asian Journal of Research and Reports in Urology

Background: Prostate cancer is the most frequently diagnosed solid malignancy among men in many regions of the world and remains one of the leading causes of cancer-related death. More than 1.4 million new cases and nearly 400,000 deaths are estimated to occur globally each year, making this disease a major and growing public health challenge. Men of African ancestry appear to be disproportionately affected, with higher incidence rates, more aggressive pathological features, and poorer survival outcomes than those reported in many other populations. In sub-Saharan Africa, demographic expansion, increasing life expectancy, and progressive improvements in diagnostic capacity have contributed to a steady rise in the number of newly diagnosed cases.

Although some prostate cancers follow an indolent clinical course, a large proportion of patients in low- and middle-income countries are diagnosed only after the disease has become locally advanced or metastatic. Delayed diagnosis is commonly associated with limited public awareness, low uptake of prostate-specific antigen testing, inadequate access to prostate biopsy and advanced imaging, and restricted availability of specialized urological and oncological services. As a consequence, many men first present with severe lower urinary tract symptoms, bone pain, spinal cord compression, pathological fractures, or obstructive renal failure.

In Cameroon, prostate cancer has emerged as one of the most frequently encountered male malignancies and constitutes an increasingly important cause of cancer-related morbidity and mortality. Hospital-based studies suggest that most patients are diagnosed after the age of 60 years and that a substantial proportion present with markedly elevated prostate-specific antigen levels, high Gleason scores, and metastatic disease at the time of initial evaluation. Structural barriers such as delayed consultation, cultural perceptions of cancer, limited diagnostic infrastructure, high out-of-pocket expenditures, and unequal geographic distribution of specialized services continue to compromise early detection and optimal treatment.

Major therapeutic advances over the past two decades have transformed the management of prostate cancer. Curative treatment is possible for localized disease through active surveillance, radical prostatectomy, and radiotherapy, while androgen deprivation therapy remains the cornerstone of treatment for advanced stages. More recently, androgen receptor–targeted agents, taxane-based chemotherapy, and novel radioligand therapies have substantially improved survival. However, access to these innovations remains limited in many African countries, where cost and infrastructure constraints continue to restrict their implementation.

This systematic review was undertaken to synthesize the available evidence on the epidemiology, risk factors, clinicopathological characteristics, diagnostic pathways, treatment patterns, and health system challenges associated with prostate cancer in Cameroon, and to identify strategic priorities that may improve prevention, early diagnosis, and patient outcomes.

Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies published between January 2010 and April 2026 were identified through PubMed/MEDLINE, Scopus, African Journals Online, and Google Scholar. Eligible publications reported epidemiological, clinical, pathological, therapeutic, economic, or health system data related to prostate cancer in Cameroon. When national data were limited, studies from comparable sub-Saharan African settings were used to provide contextual interpretation. Methodological quality was assessed using the Newcastle–Ottawa Scale, and findings were synthesized narratively because of substantial heterogeneity across study designs and outcome measures.

Results: The reviewed literature consistently shows that prostate cancer in Cameroon is predominantly diagnosed in men aged 60–75 years and that a substantial proportion of patients present with high-risk or metastatic disease. Median prostate-specific antigen concentrations at diagnosis are frequently markedly elevated, often exceeding 20–100 ng/mL, and Gleason scores of 8–10 are common. Acinar adenocarcinoma accounts for the overwhelming majority of tumors. Delayed consultation, limited screening, inadequate access to multiparametric magnetic resonance imaging and image-guided biopsy, scarcity of radiotherapy facilities, restricted availability of modern androgen receptor–targeted therapies, and high out-of-pocket costs are the principal factors associated with poor outcomes. These health system constraints frequently result in late diagnosis, treatment interruption, and reduced survival.

Conclusion: The growing burden of prostate cancer in Cameroon reflects the convergence of demographic transition, heightened genetic susceptibility among men of African ancestry, and persistent weaknesses in cancer care delivery. Although major advances in diagnosis and treatment have transformed outcomes in high-resource settings, many Cameroonian patients continue to present when curative options are no longer feasible. Strengthening public awareness, expanding access to early detection, improving pathology and imaging capacity, decentralizing oncology services, and reducing financial barriers should be considered national priorities. Without coordinated and sustained reforms, prostate cancer will remain a major and increasingly important cause of preventable morbidity and mortality among men in Cameroon.