Current Status of Prostate Biopsy in Africa: Are We Ready for a Targeted Biopsy?

Abstract

Background: Prostate cancer remains a significant public health issue globally, with considerable disparities in diagnostic and management practices, especially in Africa. Traditional diagnostic methods such as transrectal ultrasound-guided biopsies have limitations in accuracy and are associated with potential complications. Emerging targeted biopsy techniques promise improved cancer detection rates and reduced morbidity but face adoption challenges across the African continent due to variable access to advanced imaging technologies and professional expertise.

Objective: This study aims to evaluate the current practices of prostate biopsy techniques in Africa, focusing particularly on the readiness for and integration of targeted biopsy methods. It assesses the accessibility, quality, volume of procedures, and availability of advanced diagnostic tools across different regions.

Results: The survey included 58 centers across five African regions, representing a 70% response rate from an initial 83 invitations sent. Finger-guided biopsy was the most common method, used by 41 centers, while only one center reported using MRI fusion biopsy. Thirty-five centers routinely administered a rectal enema, and nearly all (n = 50) centers employed antibiotic prophylaxis, predominantly fluoroquinolones. For anesthesia, 12 centers used injectable lidocaine, and 38 centers used intrarectal lidocaine gel. The number of biopsy cores taken varied, with most centers taking 12, while others used fewer.

Conclusion: The findings indicate a critical need for concerted efforts to bridge the gap in prostate cancer diagnostics and treatment in Africa. Enhancing the quality of prostate cancer care on the continent requires investments in training, infrastructure, and standardization of practices. Collaborative efforts towards adopting advanced diagnostic tools and methods are essential for aligning African practices with global standards, ultimately improving outcomes for prostate cancer patients.