Every year we recognise Prostate Cancer Awareness Month and I applaud the efforts of community-based organisations, service clubs, government agencies in raising consciousness about this deadly disease among the male population.

It is frequently said that some men are not keen on healthy lifestyle choices, and as such health checks are not undertaken in a timely manner. As such conditions such as prostate cancer are often detected in the advance stages, resulting in financial hardship, especially for medical care; prolonged suffering; and ultimately death. Jamaicans need to be constantly reminded that, if detected early, prostate cancer can be effectively treated.

There are two main screening procedures for prostate cancer:

(1) digital rectal examination (DRE)

(2) prostate specific antigen (PSA) test

However, men seldom utilise these services, despite being available in the public and private health sectors.

Truly, there is no lack of education campaign to sensitise and mobilise men with a view to increase acceptability of these screening options. A point to note is that the attitude towards prostate cancer screening is sometimes influenced by cultural belief systems of at-risk males (generally of African descent, age 40 years and older, have a family history of prostate cancer and obesity inter alia).

Having observed the reluctance among males towards the DRE, a group of fourth-year nursing students at the University of Technology, Jamaica investigated the phenomenon. The knowledge, attitudes and practices of male employees at a selected university regarding DRE were examined. Of the 135 males surveyed, 50 per cent were from the age group 40 years to over 60 years and 62 per cent held a bachelor’s degree or a higher level of education.

They found that, while 60 per cent of the males surveyed were aware of the DRE, 37 per cent had limited knowledge of what the procedure entails. Equally important were the findings of the study which revealed that 88 per cent of the males felt that the DRE is an important screening test that men should embrace, generally.

Some 46 per cent of the males maintained neutral attitudes toward the DRE, 20 per cent expressed negative attitudes toward the procedure. Further, 19 per cent expressed morbid fear of the procedure which involves a digit/finger being inserted into the rectum in order to feel the prostate. This negative attitudes and level of fear among the males were associated with the view that an examination result may be positive for cancer and other abnormalities.

So why is acceptability of the DRE so low among Jamaican men? Despite being aware, and having some knowledge of the procedure, only 18 per cent of the males surveyed had the procedure performed. It is true that some males feel that the procedure is intrusive and associate it with homosexual practices. The findings of the study, however, revealed that 87 per cent of the males surveyed did not agree that homosexual practices were associated with the examination. In addition, 8 per cent of the males argued that their reluctance to have the procedure done was due mainly to the discomfort felt during the procedure.

On a positive note, of the males surveyed, 51 per cent agreed that they would encourage a friend to do the DRE in order to screen for prostate cancer.

While the findings of the study cannot be generalised to other populations, it has shown that more work needs to done to positively affect the attitudes of males regarding the DRE. As has been noted, DRE can result in early detection of prostate cancer; thereby reducing the morbidity and mortality associated with the disease. Improving acceptability of the procedure among males is paramount, even as we seek to improve their quality of life.

Dr Adella Campbell is associate professor and dean of the College of Health Sciences at the University of Technology, Jamaica.