Early Diagnosis Challenges and Histoprognostics Factors of Prostate Cancer in Burkina Faso: A 10-Year Study of 1,572 Cases

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Résumé

Introduction. Prostate cancer is a growing public health issue in Africa. This study aimed to describe the histo-epidemiological characteristics, evaluate histoprognostic factors, and identify the primary drivers of diagnostic delay in prostate cancers diagnosed in Burkina Faso between 2014 and 2023. Methods. A descriptive and analytical cross-sectional study with retrospective data collection was conducted across all pathology laboratories in Burkina Faso. Statistical analysis utilized Student's t-test, Fisher's exact test, Pearson's chi-square test, Cramér's V, and Spearman's rank correlation (p < 0.05). Results. Over a ten-year period, 3,994 prostate specimens were analyzed across anatomical pathology laboratories in Burkina Faso. Prostate cancer was identified in 1,572 cases, including 1,501 primary malignancies (prevalence: 37.58%; mean: 150.1 cases/year). The mean patient age was 70.11 ± 8.33 years. Mean total PSA (tPSA) level was 410.88 ng/mL, with 92.55% of patients presenting with levels ≥ 10 ng/mL. Acinar adenocarcinoma was the predominant histological subtype (98.34%). Gleason score 7 (46.43%) and ISUP grade group 1 (31.68%) were the most frequent. Perineural invasion, lymphovascular invasion, high-grade prostatic intraepithelial neoplasia (HGPIN) lesions, and periprostatic adipose tissue infiltration were observed in 35.75%, 7.50%, 9.75%, and 26.25% of cases, respectively. The association between digital rectal examination (DRE) findings and Gleason score was statistically significant (p = 0.0002, Cramér's V = 0.3011). The correlation coefficient (rho) between tPSA and Gleason score was 0.32. Conclusion. Prostate cancer in Burkina Faso is characterized by diagnosis at an advanced stage. Implementing targeted screening protocols along with binary and standardized histopathological reporting represent key priorities to optimize patient management.

Mots-clés

prostate; cancer; histoprognostic factors; digital rectal examination; tPSA; Gleason; ISUP; Burkina Faso