The Risk Factors and Screening Uptake for Prostate Cancer: A Scoping Review

OBJECTIVES

The purpose of this scoping review was to identify the risk factors and screening uptake for prostate cancer.

DESIGN

Scoping review.

METHODS

Arksey and O'Malley's framework guided this review; five databases (Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Academic Search Complete and Cochrane Library) and grey literature were searched. Screening was undertaken against predetermined inclusion criteria for articles published before July 2023 and written in English. This review is reported in line with PRISMA-Sc.

RESULTS

10,899 database results were identified; 3676 papers were removed as duplicates and 7115 papers were excluded at title and abstract review. A total of 108 papers were full-text reviewed and 67 were included in the review. Grey literature searching yielded no results. Age, family history/genetics, hormones, race/ethnicity, exposure to hazards, geographical location and diet were identified as risk factors. Prostatic antigen test (PSA), digital rectal examination (DRE), transrectal ultrasound (TRUS), magnetic resonance imaging (MRI), magnetic resonance spectroscopic imaging (MRSI) and prostate biopsy were identified as screening/diagnostic methods. The evidence reviewed highlights moderate knowledge and screening uptake of prostate cancer with less than half of men reporting for PSA screening. On the other hand, there is a year-to-year increase in PSA and DRE screening, but factors such as poverty, religion, culture, communication barriers, language and costs affect men's uptake of prostate cancer screening.

CONCLUSION

As prostate cancer rates increase globally, there is a need for greater uptake of prostate cancer screening and improved health literacy among men and health workers. There is a need to develop a comprehensive prostate cancer awareness and screening programme that targets men and addresses uptake issues so as to provide safe, quality care.

STRENGTHS AND LIMITATIONS OF THIS STUDY

(1) A broad search strategy was utilised incorporating both databases and grey literature. (2) The PRISMA reporting guidelines were utilised. (3) Only English language papers were included, and this may have resulted in relevant articles being omitted.

TNF-α controls Lipocalin-2 expression in PC-3 prostate cancer cells

Prostate cancer (PCa) is one of the most common and deadly cancers in men worldwide. The surrounding tumor microenvironment (TME) is important in tumor progression, as cytokines and soluble mediators including tumor necrosis factor (TNF-α) or lipocalin-2 (LCN2) can influence tumor growth and formation of metastasis. The exact mechanisms on how these pleiotropic factors affect PCa are still unknown. In this study, we showed for the first time that LCN2 mRNA and protein expression are strongly inducible by TNF-α in the highly metastatic human PCa cell line PC-3. In addition, we observed higher levels of secreted LCN2 in cell culture medium of TNF-α-treated PC-3 cells. We found that different signaling pathways such as p38, NF-κB or JNK were activated shortly after TNF-α treatment. Moreover, the mRNA levels of IL-1β and IL-8 were also significantly increased after 24 h stimulation. Mechanistically, the NF-κB pathway and the JNK signaling axis are directly responsible for LCN2 upregulation. This was shown by the fact that pretreatment with the JNK inhibitors SP600125 or JNK-IN-8 strongly downregulated phosphorylation of c-Jun protein and markedly reduced TNF-α-mediated LCN2 upregulation in PC-3 cells. Likewise, the NF-κB inhibitor QNZ was able to repress TNF-α-induced LCN2 expression in PC-3 cells. Taking into consideration that LCN2 has been described as a tumor promoting factor in PCa, our results indicate that JNK regulates LCN2 expression and unmasks the JNK signaling axis as a possible therapeutic target for patients with PCa.

Lifestyle and Dietary Factors and Prostate Cancer Risk: A Multicentre Case-Control Study

This study aims to explore the association between fruit and vegetable intake, high fat, body mass index (BMI) score, physical activity, and the occurrence of prostate cancer among Jordanian men. A case-control study was conducted in three large referral hospitals. The sample included 165 prostate cancer patients in the case group and 177 healthy participants in the control group. The results showed that smoking (odds ratio [OR] = 0.32; 95% confidence interval [CI] = [0.18, 0.57]), a history of prostate infection (OR = 0.21; 95% CI = [0.11, 0.38]), high-fat intake (OR = 0.44; 95% CI = [0.23, 0.85]), and increased mean of BMI (OR = 1.08; 95% CI = [1.02, 1.13]) increased the likelihood of developing prostate cancer. Healthy diet and giving up smoking are recommended, as they may contribute to a reduction in the incidence of prostate cancer. More randomized clinical trials in this area are needed to strengthen the available evidence and reduce the effects of confounding variables.

Prostate cancer overview

OBJECTIVES

To review prostate anatomy, epidemiology and risk factors, presentation and diagnosis, staging and treatment, emerging therapies, and patient education.

DATA SOURCES

Review of current and classic literature.

CONCLUSION

Patients must be educated regarding screening recommendations and offered evidence-based guidance regarding the risks, benefits, and alternatives to treatment. Adverse effects of treatment may impact quality of life.

IMPLICATIONS FOR NURSING PRACTICE

As the incidence of prostate cancer continues to rise, nurses will play an essential role in the treatment and counseling of men facing this malignancy. Nursing research will also be necessary to further investigate quality-of-life concerns and evidence-based practice regarding symptom management.