title: What Prevents Men Aged 40-64 Years from Prostate Cancer Screening in Namibia?
abstract: Objectives. Although a growing body of evidence demonstrates the public health burden of prostate cancer in SSA, relatively little is known about the underlying factors surrounding the low levels of testing for the disease in the context of this region. Using Namibia Demographic Health Survey dataset (NDHS, 2013), we examined the factors that influence men's decision to screen for prostate cancer in Namibia. Methods. We use complementary log-log regression models to explore the determinants of screening for prostate cancer. We also corrected for the effect of unobserved heterogeneity that may affect screening behaviours at the cluster level. Results. The results show that health insurance coverage (OR = 2.95, p = 0.01) is an important predictor of screening for prostate cancer in Namibia. In addition, higher education and discussing reproductive issues with a health worker (OR = 2.02, p = 0.05) were more likely to screening for prostate cancer. Conclusions. A universal health insurance scheme may be necessary to increase uptake of prostate cancer screening. However it needs to be acknowledged that expanded screening can have negative consequences and any allocation of scarce resources towards screening must be guided by evidence obtained from the local context about the costs and benefits of screening.
authors.affiliation: Department of Geography and Environment, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1.
authors.forename: Joseph
authors.initials: J
authors.lastname: Kangmennaang
authors.affiliation: The Institute of Interdisciplinary Studies, 2201 Dunton Tower, 1125 Colonel By Drive, Ottawa, ON, Canada K1S 5B6.
authors.forename: Paul
authors.initials: P
authors.lastname: Mkandawire
authors.affiliation: Department of Geography, Western University, 1151 Richmond Street, London, ON, Canada N6A 5C2.
authors.forename: Isaac
authors.initials: I
authors.lastname: Luginaah