Scientists and cancer researchers in the country and across Africa are intensifying efforts to uncover the reasons behind the disproportionately high cases of prostate cancer among black men, a concern that has puzzled the global medical community for decades.
According to reports, African men are among the most affected globally by prostate cancer, yet the specific reasons remain elusive.
Professor. Njoki Maina, a molecular biologist and cancer genomics’ expert from the University of Nairobi’s Department of Biochemistry, says prostate and esophageal cancers are among the leading cancers impacting the Kenyan men.
“Black men are disproportionately affected by prostate cancer, and nobody yet can really put a finger on it. The genome of Africans is not well understood, and what we need to do is, to go back to the basics of what is in our genome as Africans and see what it advises us in matters of the diseases that affect our people, and how we respond to treatment” Prof. Maina emphasized.
As a basic science researcher, Prof. Maina is delving into the Kenyan male genome to explore underlying genetic factors that may contribute to prostate cancer. Her research focusses on identifying biomarkers – genes and immune system signals that could enable early detection.
“We are still in that formative phase, but our goal is to identify biomarkers that guide early screening and intervention,” she noted.
Despite these progressive plans, research in the region continues to be hampered by limited funding, inadequate infrastructure, and insufficient capacity, which is a challenge common across the continent.
Prof. Maina, however, believes that African scientists and researchers have the expertise needed to address the continents’ cancer burden.
In collaboration with researchers based at the University of Manchester, U.K., her work initially began with studies on esophageal cancer using samples from Kenyan populations. The partnership incorporates advanced techniques such as bioinformatics and data science.
“Currently, I am co-supervising a PhD. student, Accadius Lunayo, he is a computational biologist expert in Prof David Wedge’s Genomics and Data Science lab at UoM. We are integrating lab and computational work to identify genetic signatures for esophageal cancer,” she said. “Once published, this study design and data management protocols will also help unlock insights into other cancers like prostate, breast, colorectal and cervical cancers among the 5 leading cancers bothering the African population ”
A key aspect in their research work includes spatial transcriptomics, which studies directly gene activity in single cells on a cancer biopsy tissue within the tumor.
“Different cells within one tumor can tell us unique story. Understanding these cancer environments could help detect cancers in early or even pre-cancerous stages, which is exactly what Africa needs,” she added.
According to the World Health Organization (WHO), over 1.41 million new prostate cancer were recorded globally in 2020. The World Cancer Research Fund reported more than 1.46 million new cases in 2022, while the Global Cancer Observatory placed Africa’s burden at 103,050 cases the same year.
In the context of Kenya, prostate cancer (PC) represents the predominant malignancy among the male population, exhibiting an Age-Standardized Incidence Rate (ASR) of 40.6 per 100,000 individuals. As reported in the Global Cancer Statistics 2022 (GLOBOCAN), prostate cancer constitutes the most frequently diagnosed cancer in Kenyan males, accounting for 21.9% of all newly identified cancer cases in this demographic.
The disease is characterized by a significantly elevated mortality rate, which is largely attributable to delayed diagnosis and the scarcity of effective early screening methodologies.
The challenges associated with early detection are exacerbated by the absence of non-invasive diagnostic modalities, an excessive dependence on digital rectal examinations, and a prevailing perception of low self-vulnerability among men. As a result, the majority of patients receive their diagnosis at advanced stages of the disease upon hospital admission.
Yet screening and awareness remain low. While 61% of men are aware of Prostate cancer, a paltry 4% of them go for screening, a gap attributed to stigma, fear of diagnosis and constrained financial capabilities to accessing treatment.
Though cancer is fundamentally a genetic disease, scientists affirm that only 7% of cancers are of a familial origin and are therefore categorized as Hereditary cancers.
“A staggering 93% of cancer cases are referred to as lifestyle diseases; how we eat, the sedentary lifestyles we live, the lack of screening and also the environmental exposure to chemicals such as herbicides and pesticides used in our farms and suspected to be carcinogenic are some of the causes of the cancers we witness” Prof. Maina explained.
She emphasized that policy makers must play a critical role in addressing environmental and systemic factors contributing to cancer prevalence.
To mitigate the risk, men at age of 40 and above are advised to undergo annual Prostate Specific-Antigen or PSA test, a non-invasive alternative to the traditional screening methods.
Prof Maina also highlighted the importance of African-led research collaboration.
“Collaborative research is crucial, but we must build local capacity so that we can contribute equally to global knowledge and advocate for Africa’s unique health needs,” she concluded.
