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Clinical Research

Prevalence of BPH and lower urinary tract symptoms in West Africans

Prostate Cancer and Prostatic Diseases volume 15, pages 170–176 (2012)Cite this article

Abstract

Background:

BPH and lower urinary tract symptoms (LUTS) are very common among older men in Western countries. However, the prevalence of these two conditions in the developing countries is less clear.

Methods:

We assessed the age-standardized prevalence of BPH and/or LUTS among West Africans in a probability sample of 950 men aged 50–74 in Accra, Ghana, with no evidence of biopsy-confirmed prostate cancer after screening with PSA and digital rectal examination (DRE). Information on LUTS was based on self-reports of the International Prostate Symptom Score (IPSS). BPH was estimated using DRE, PSA levels and imputed prostate volume.

Results:

The prevalence of DRE-detected enlarged prostate was 62.3%, while that of PSA⩾1.5 ng ml–1 (an estimate of prostate volume ⩾ 30 cm3) was 35.3%. The prevalence of moderate-to-severe LUTS (IPSS⩾8) was 19.9%. The prevalence of IPSS⩾8 and an enlarged prostate on DRE was 13.3%. Although there is no universally agreed-upon definition of BPH/LUTS, making comparisons across populations difficult, BPH and/or LUTS appear to be quite common among older Ghanaian men.

Conclusions:

We found that after age standardization, the prevalence of DRE-detected enlarged prostate in Ghanaian men is higher than previously reported for American men, but the prevalence of LUTS was lower than previously reported for African Americans. Further studies are needed to confirm these findings and identify the risk factors for BPH in both Africans and African Americans.

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References

  1. Wei JT, Calhoun EA, Jacobsen SJ . Benign Prostatic hyperplasia. In: Litwin MS, Saigal CS (eds). Urologic Diseases in America. DHHS, PHS, NIH, NIDDK—Government Printing Office: Washington, DC, 2007; pp 43–67.

    Google Scholar 

  2. Berry SJ, Coffey DS, Walsh PC, Ewing LL . The development of human benign prostatic hyperplasia with age. J Urol 1984; 132: 474–479.

    Article  CAS  Google Scholar 

  3. Oesterling JE . Benign prostatic hyperplasia: a review of its histogenesis and natural history. Prostate Suppl 1996; 6: 67–73.

    Article  CAS  Google Scholar 

  4. Girman CJ . Population-based studies of the epidemiology of benign prostatic hyperplasia. Br J Urol 1998; 82 (Suppl 1): 34–43.

    Article  Google Scholar 

  5. Barry MJ, Fowler Jr FJ, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol 1992; 148: 1549–1557.

    Article  CAS  Google Scholar 

  6. Bosch JL, Hop WC, Kirkels WJ, Schroder FH . The International Prostate Symptom Score in a community-based sample of men between 55 and 74 years of age: prevalence and correlation of symptoms with age, prostate volume, flow rate and residual urine volume. Br J Urol 1995; 75: 622–630.

    Article  CAS  Google Scholar 

  7. Sarma AV, Wei JT, Jacobson DJ, Dunn RL, Roberts RO, Girman CJ et al. Comparison of lower urinary tract symptom severity and associated bother between community-dwelling black and white men: the Olmsted County Study of Urinary Symptoms and Health Status and the Flint Men's Health Study. Urology 2003; 61: 1086–1091.

    Article  Google Scholar 

  8. Kok ET, Bohnen AM, Jonkheijm R, Gouweloos J, Groeneveld FP, Thomas S et al. Simple case definition of clinical benign prostatic hyperplasia, based on International Prostate Symptom Score, predicts general practitioner consultation rates. Urology 2006; 68: 784–789.

    Article  Google Scholar 

  9. Naslund MJ, Gilsenan AW, Midkiff KD, Bown A, Wolford ET, Wang J . Prevalence of lower urinary tract symptoms and prostate enlargement in the primary care setting. Int J Clin Pract 2007; 61: 1437–1445.

    Article  CAS  Google Scholar 

  10. Markland AD, Thompson IM, Ankerst DP, Higgins B, Kraus SR . Lack of disparity in lower urinary tract symptom severity between community-dwelling non-Hispanic white, Mexican-American, and African-American men. Urology 2007; 69: 697–702.

    Article  Google Scholar 

  11. Glasser DB, Carson 3rd C, Kang JH, Laumann EO . Prevalence of storage and voiding symptoms among men aged 40 years and older in a US population-based study: results from the Male Attitudes Regarding Sexual Health study. Int J Clin Pract 2007; 61: 1294–1300.

    Article  CAS  Google Scholar 

  12. Trueman P, Hood SC, Nayak US, Mrazek MF . Prevalence of lower urinary tract symptoms and self-reported diagnosed ‘benign prostatic hyperplasia’, and their effect on quality of life in a community-based survey of men in the UK. BJU Int 1999; 83: 410–415.

    Article  CAS  Google Scholar 

  13. Norman RW, Nickel JC, Fish D, Pickett SN . ‘Prostate-related symptoms’ in Canadian men 50 years of age or older: prevalence and relationships among symptoms. Br J Urol 1994; 74: 542–550.

    Article  CAS  Google Scholar 

  14. Sagnier PP, MacFarlane G, Richard F, Botto H, Teillac P, Boyle P . Results of an epidemiological survey using a modified American Urological Association symptom index for benign prostatic hyperplasia in France. J Urol 1994; 151: 1266–1270.

    Article  CAS  Google Scholar 

  15. Braun MH, Sommer F, Haupt G, Mathers MJ, Reifenrath B, Engelmann UH . Lower urinary tract symptoms and erectile dysfunction: co-morbidity or typical ‘Aging Male’ symptoms? Results of the ‘Cologne Male Survey’. Eur Urol 2003; 44: 588–594.

    Article  CAS  Google Scholar 

  16. Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol 2003; 44: 637–649.

    Article  Google Scholar 

  17. Kupelian V, Wei JT, O’Leary MP, Kusek JW, Litman HJ, Link CL et al. Prevalence of lower urinary tract symptoms and effect on quality of life in a racially and ethnically diverse random sample: the Boston Area Community Health (BACH) Survey. Arch Intern Med 2006; 166: 2381–2387.

    Article  Google Scholar 

  18. Taylor BC, Wilt TJ, Fink HA, Lambert LC, Marshall LM, Hoffman AR et al. Prevalence, severity, and health correlates of lower urinary tract symptoms among older men: the MrOS study. Urology 2006; 68: 804–809.

    Article  Google Scholar 

  19. Parsons JK, Bergstrom J, Silberstein J, Barrett-Connor E . Prevalence and characteristics of lower urinary tract symptoms in men aged > or = 80 years. Urology 2008; 72: 318–321.

    Article  Google Scholar 

  20. Boyle P, Robertson C, Mazzetta C, Keech M, Hobbs FD, Fourcade R et al. The prevalence of lower urinary tract symptoms in men and women in four centres. The UrEpik study. BJU Int 2003; 92: 409–414.

    Article  CAS  Google Scholar 

  21. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T et al. Cancer statistics, 2008. CA Cancer J Clin 2008; 58: 71–96.

    Article  Google Scholar 

  22. Platz EA, Kawachi I, Rimm EB, Willett WC, Giovannucci E . Race, ethnicity and benign prostatic hyperplasia in the health professionals follow-up study. J Urol 2000; 163: 490–495.

    Article  CAS  Google Scholar 

  23. Platz EA, Smit E, Curhan GC, Nyberg LM, Giovannucci E . Prevalence of and racial/ethnic variation in lower urinary tract symptoms and noncancer prostate surgery in US men. Urology 2002; 59: 877–883.

    Article  Google Scholar 

  24. Roehrborn CG, Boyle P, Gould AL, Waldstreicher J . Serum prostate-specific antigen as a predictor of prostate volume in men with benign prostatic hyperplasia. Urology 1999; 53: 581–589.

    Article  CAS  Google Scholar 

  25. Bosch JL, Bohnen AM, Groeneveld FP . Validity of digital rectal examination and serum prostate specific antigen in the estimation of prostate volume in community-based men aged 50–78 years: the Krimpen Study. Eur Urol 2004; 46: 753–759.

    Article  CAS  Google Scholar 

  26. SUDAAN Language Manual, Release 9.0. Research Triangle Institute: Research Triangle Park, NC, 2004.

  27. Ahmad OE, Boschi-Pinto C, Lopez AD, Murray CJ, Lozano R, Inoue M . Age standardization of rates: a new WHO standard. GPE Discussion Paper Series. World Health Organization: Geneva, 2000.

    Google Scholar 

  28. Guess HA, Arrighi HM, Metter EJ, Fozard JL . Cumulative prevalence of prostatism matches the autopsy prevalence of benign prostatic hyperplasia. Prostate 1990; 17: 241–246.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank Ms Evelyn Tay and Ms Vicky Okyne for their expert help in coordinating the study; consultants/resident urologists, pathologists, nurses and interviewers of Korle-Bu Hospital and University of Ghana Medical School for their assistance with subject enrollment, screening and clinical examination; the study participants for their contribution toward a better understanding of prostate disease; Ms Violet Devairakkam, Ms Norma Kim and Mr John Heinrich of Research Triangle Institute (RTI) for their expert study management; and Ms Ann Truelove of Westat for study support and data management. This research was supported by the Intramural Research Program of the National Cancer Institute, National Institutes of Health.

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Authors and Affiliations

  1. UC Berkeley School of Public Health, University of California, Berkeley, CA, USA

    A P Chokkalingam

  2. University of Ghana Medical School, Accra, Ghana

    E D Yeboah, R B Biritwum, Y Tettey & A Adjei

  3. Brady Urological Institute, Johns Hopkins University, Baltimore, MD, USA

    A DeMarzo, G Netto, S Jadallah & A Partin

  4. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA

    K Yu, Y Li, L W Chu, R N Hoover & A W Hsing

  5. University of California at Los Angeles, Rockville, MD, USA

    D Chia

  6. Westat, Rockville, MD, USA

    S Niwa

  7. University of Texas Health Science Center, San Antonio, TX, USA

    I M Thompson

  8. University of Texas Southwestern Medical Center, Dallas, TX, USA

    C Roehrborn

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  1. A P Chokkalingam
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  15. I M Thompson
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Correspondence to A P Chokkalingam or A W Hsing.

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Chokkalingam, A., Yeboah, E., DeMarzo, A. et al. Prevalence of BPH and lower urinary tract symptoms in West Africans. Prostate Cancer Prostatic Dis 15, 170–176 (2012). https://doi.org/10.1038/pcan.2011.43

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  • DOI: https://doi.org/10.1038/pcan.2011.43

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