Clinicopathological features, management, and treatment outcome of prostate cancer in West and Central Africa: a systematic review

Abstract

Background Prostate cancer represents a significant and growing global health disparity, with men of African descent experiencing the highest incidence and poorest survival outcomes worldwide. This systematic review aims to comprehensively synthesize the fragmented literature to determine the specific clinicopathological features, prevailing management strategies, and treatment outcomes of prostate cancer across the 25 nations of West and Central Africa (WCA). Method A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, encompassing primary research articles published between January 2010 and July 2025. Comprehensive searches were performed across Scopus, PubMed, and Web of Science, targeting country-specific data from WCA. Studies reporting on clinicopathological features, treatment modalities, or survival outcomes were included. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Result A total of 25 studies (16 case series, 7 cohorts, 2 quasi-experimental) were included, with the majority originating from Nigeria, Senegal, and Ghana. Clinicopathological features consistently demonstrated a late-stage presentation: mean/median Prostate-Specific Antigen levels frequently exceeded 100 ng/mL, and a significant proportion of cases were categorized as highly aggressive disease (Gleason Grade Group 4 and 5). Consequently, the predominant management strategy was palliative systemic therapy, primarily Androgen Deprivation Therapy, with curative local therapies (surgery/radiation) being infrequently reported. Conclusion Prostate cancer in WCA is characterized by a worsening phenotype associated with a diagnosis at an advanced stage, leading to a management paradigm dominated by palliative care. Urgent, regionally-tailored public health interventions are required to establish effective early detection programs and bolster local oncology capacity to transition from palliative to curative intent treatment and improve survival outcomes