Landscape of Prostate Cancer Biomarkers in Sub-Saharan Africa: A scoping review

Prostate cancer (PCa) is a global public health challenge, representing the second most commonly diagnosed cancer and the fourth leading cause of cancer death among men. Apart from genetic factors and an increase in age, African ancestry is a major risk factor associated with PCa. In Sub-Saharan Africa (SSA), PCa has a higher incidence and mortality rate, indicating greater genetic susceptibility observed among men in that region and differences in diagnostic practices. Thus, highlighting the need for biomarkers that can efficiently detect and stratify the disease aggressiveness; however, they are cost-effective for a population from SSA. The standard biomarker testing for PCa globally is prostate-specific antigen (PSA), as having the test increases the chances of early detection. However, a major challenge is its inability to distinguish between clinically significant and insignificant PCa and the possibility of overdiagnosis and overtreatment. Apart from this, the affordability of PSA is a challenge for the SSA population. In a bid to address these challenges, several PCa biomarkers have been validated. Thus, there is a need to investigate, identify, and conduct comparative studies on the landscape of prostate cancer biomarkers utilized in SSA. This should ultimately provide important information on available and cost-efficient PC biomarker options for SSA, which can be utilized for diagnosis, thus contributing to the reduction of the mortality rate in the SSA population with prostate cancer. Notably, more evidence is available regarding PCa biomarkers and their expression in developed countries compared to those in Sub-Saharan African countries. This scoping review focuses on the landscape of biomarkers (type, efficiency, expression, availability, affordability and cost-effectiveness) associated with prostate cancer in SSA. For this review, we will search different databases, including PubMed, Scopus, and Web of Science using a search protocol designed specifically for this study. The titles, abstracts, and full texts will be assessed independently by two reviewers (selected authors: ASO and ADB) on Rayyan, and data from the selected studies will be extracted and analyzed. The potential findings from this review could contribute significantly to ongoing research on prostate cancer for the following reasons. First, the identification and suggestion of the panels of PCa biomarkers commonly utilized in SSA. Second, the efficiency of the PCa biomarker expression used. Lastly, the identified biomarkers' cost-effectiveness and availability for PCa diagnosis in SSA countries might ensure their relevance to translational oncology, precision medicine, and regional diagnostic needs.