Main Article Content

Ali Akbar1, Syed Adnan2, Danish Khilani3, Haider Ali4, Dr Haseeb Umar5* Dr. Naseem Akhter6


Men's Health; Primary Healthcare; Prostate Specific Antigen; Situational Analysis.


Men's health remains a challenge in Pakistanian healthcare due to societal taboos and ineffective primary care strategies. This leads to a demand for specialized healthcare, resulting in higher costs and male mortality rates, particularly concerning prostate cancer.

Objective: This study aims to identify morbidity and mortality related to prostate cancer in the Pakistanian male population, assess the implementation status of the National Men's Comprehensive Health Care Policy, and propose interventions based on identified issues.

Methods: An ecological, demographic, cross-sectional, retrospective, descriptive-analytical, and quantitative study was conducted using data collected between June 2019 and May 2020. Situational analysis and GUT and Ishikawa theories were applied.

Results: In Primary Care, from June 2019 to May 2020, only 3% of the male population underwent prostate-specific antigen (P.S.A.) screening. The P.S.A. screening objective outlined in the annual management report (R.A.G.) was suboptimal, with primary care professionals often disregarding P.S.A. testing as a screening method. Lack of public education regarding the significance of prostate cancer also contributes to low screening rates.

Conclusion: The proposed intervention addresses the identified issues by defining screening protocols, increasing public awareness, and aligning recommendations between the Ministry of Health and the Pakistanian Society of Urology. These efforts are crucial for improving men's healthcare outcomes and reducing prostate cancer mortality in Pakistan.

Abstract 159 | PDF Downloads 49


1. Ahima, R. S., & Dias, J. P. (2024). Connecting Obesity and Reproductive Disorders Metabolic Syndrome: A Comprehensive Textbook (pp. 659-674): Springer.
2. Asif, A., Nathan, A., Ng, A., Khetrapal, P., Chan, V. W.-S., Giganti, F., . . . Lorgelly, P. (2023a). Comparing parametric to multiparametric M.R.I. in the diagnosis of clinically significant prostate cancer in biopsy-naive men (PRIME): a prospective, international, multicentre, non-inferiority within-patient, diagnostic yield trial protocol. B.M.J. Open, 13(4).
3. Asif, A., Nathan, A., Ng, A., Khetrapal, P., Chan, V. W.-S., Giganti, F., . . . Lorgelly, P. (2023b). Protocol: Comparing parametric to multiparametric M.R.I. in diagnosing clinically significant prostate cancer in biopsy-naive men (PRIME): a prospective, international, multicentre, non-inferiority within-patient, diagnostic yield trial protocol. B.M.J. open, 13(4).
4. Belkora, J. K., Broering, J. M., Neuhaus, J., Zargham, A., Weinberg, T., Witte, J. S., . . . Carroll, P. R. (2023). Controlled trial of decision support for men with early-stage prostate cancer: brief research report of effects on patient knowledge. Frontiers in Urology, 3, 1127089.
5. Birkner, D. R., Schettle, M., Feuz, M., Blum, D., & Hertler, C. (2024). Outpatient Palliative Care Service Involvement: A Five-Year Experience from a Tertiary Hospital in Switzerland. Palliative Medicine Reports, 5(1), 10-19.
6. Cani, M., Epistolio, S., Dazio, G., Modesti, M., Salfi, G., Pedrani, M., . . . Tortola, L. (2024). Antiandrogens as Therapies for COVID-19: A Systematic Review. Cancers, 16(2), 298.
7. Chapman, C., Jayasekera, J., Dash, C., Sheppard, V., & Mandelblatt, J. (2023). A health equity framework to support the next generation of cancer population simulation models. JNCI Monographs, 2023(62), 255-264.
8. Chen, A. M., Garcia, A. D., Alexandrescu, M., Truong, A., & Senthil, M. (2024). Effect of a Same-Day-Appointment Initiative on Access-Related Benchmarks in Radiation Oncology. Practical Radiation Oncology, 14(1), 12-19.
9. Cornford, P., Halpin, C., Sassmann, J., Frankcom, I., & Braybrook, S. (2023). Increased use of 6-monthly gonadotropin-releasing hormone agonist therapy for prostate cancer: a capacity and cost-minimization analysis for England. Journal of Medical Economics, 26(1), 208-218.
10. de Andrade, K. C., Strande, N. T., Kim, J., Haley, J. S., Hatton, J. N., Frone, M. N., . . . Schneider, C. (2024). The genome-first approach of the prevalence and cancer phenotypes of pathogenic or likely pathogenic germline TP53 variants. Human Genetics and Genomics Advances, 5(1).
11. de Vos, I. I., Drost, F.-J. H., Bokhorst, L. P., Alberts, A. R., van Gelder, M., Herman, E. M., . . . Roobol, M. J. (2023). Prostate cancer risk assessment by the primary care physician and urologist: transabdominal-versus transrectal ultrasound prostate volume-based use of the Rotterdam Prostate Cancer Risk Calculator. Translational Andrology and Urology, 12(2), 241.
12. Diaz, K. A., Amaya, S. L., & García-Perdomo, H. A. (2023). Perspectives on prostate cancer: advances and pending challenges for a multidisciplinary oncological approach in South America. International Urology and Nephrology, 1-7.
13. Greenspan, S., Chandra, M., Joo, H. W., Sapir, N., Gorman, J., Yang, J., . . . Shroyer, A. L. L. (2023). PROTOCOL: New York State Race, Ethnicity, and Insurance Disparities in Follow-up Prostate Cancer Screening.
14. Gunn, C. M., Li, E. X., Gignac, G. A., Pankowska, M., Loo, S., Zayhowski, K., & Wang, C. (2023). Delivering genetic testing for patients with prostate cancer: moving beyond provider knowledge as a barrier to care. Cancer Control, 30, 10732748221143884.
15. Harper, J. B., Greenberg, S. E., Hunt, T. C., Cooney, K. A., & O'Neil, B. B. (2023). Initial outcomes and insights from a novel, high‐risk prostate cancer screening clinic. The Prostate, 83(2), 151-157.
16. Harris, N. L., Cayama, M. R., Arias, C., Ansari, F., Ilonzo, C., Williams, A., . . . Kirby, R. S. (2023). Assessing Men's Unmet Preconception Care Needs in the United States by Race/Ethnicity and Nativity. Sexual & Reproductive Healthcare, 36, 100840.
17. Herrera, D. J., van de Veerdonk, W., Berhe, N. M., Talboom, S., van Loo, M., Alejos, A. R., . . . Van Hal, G. (2023). Mixed-Method Systematic Review and Meta-Analysis of Shared Decision-Making Tools for Cancer Screening. Cancers, 15(15), 3867.
18. Hofmarcher, A. P. T. Tackling European Union cancer care inequalities.
19. Khan, Y., Verhaeghe, N., De Pauw, R., Devleesschauwer, B., Gadeyne, S., Gorasso, V., . . . Vandemaele, M. (2023). Evaluating the health and health economic impact of the COVID-19 pandemic on delayed cancer care in Belgium: A Markov model study protocol. PLoS ONE, 18(10), e0288777.
20. Liemburg, G. B., Korevaar, J. C., Logtenberg, M., Berendsen, A. J., Berger, M. Y., & Brandenbarg, D. (2024). Cancer follow-up in primary care after treatment with curative intent: Views of breast and colorectal cancer patients. Patient Education and Counseling, 122, 108139.
21. Lofters, A., Khalil, I., Sopcak, N., Shea-Budgell, M., Meaney, C., Fernandes, C., . . . Manca, D. P. (2023). Opportunities to improve primary care quality for cancer survivors: findings from the BETTER WISE study. Supportive Care in Cancer, 31(7), 430.
22. Lotan, Y., Agarwal, P., Black, P., Dickstein, R., Kamat, A. M., Lee, B., . . . Smith, A. K. (2024). Standardization of evaluating and surveillance patients with B.C.G. unresponsive high-grade non-muscle invasive bladder cancer clinical trials. Paper presented at the Urologic Oncology: Seminars and Original Investigations.
23. Louw, C. J., de Haan, P., Verpoorte, E., & Baker, P. (2024). Efficient Electrochemiluminescence Sensing in Microfluidic Biosensors: A Review. Critical Reviews™ in Biomedical Engineering, 52.
24. Ma, F., Zhu, Y., & Liu, Y. (2024). The relationship between psychological distress and the nursing humanistic care demands in postoperative cancer inpatients: a cross-sectional study. BMC nursing, 23(1), 26.
25. Morelli, V. (2023). Social Determinants of Health: An Overview for the Primary Care Provider. Primary Care: Clinics in Office Practice.
26. Mukherjee, S. D., Bainbridge, D., Hillis, C., & Sussman, J. (2023). Optimizing Cancer Survivorship Care: Examination of Factors Associated with Transition to Primary Care. Current Oncology, 30(3), 2743-2750.
27. Nemirovsky, D. R., Klose, C., Wynne, M., McSweeney, B., Luu, J., Chen, J., . . . Haji-Momenian, S. (2023). Role of Race and Insurance Status in Prostate Cancer Diagnosis-to-Treatment Interval. Clinical Genitourinary Cancer, 21(3), e198-e203.
28. Panayi, Z., & Srirangam, S. J. (2023). Prostate cancer among South Asian men in the United Kingdom: A systematic review. Journal of Clinical Urology, 20514158221145775.
29. Pinsky, P. F., & Parnes, H. (2023). Screening for prostate cancer. New England Journal of Medicine, 388(15), 1405-1414.
30. Pradhan, A. B., Nicholls, E., Edwards, J. J., Welsh, V., & Paskins, Z. (2024). Bone health assessment in adults with fragility fracture risk factors between 2002–2014: a retrospective cohort study. BJGP open.
31. Radulovikj, M., & Mitevski, M. (2023). The Importance of Men's Health Care. Annual of the Faculty of Philosophy in Skopje, 76(1), 831-842.
32. Sandell, T., Schütze, H., & Miller, A. (2023). Acceptability of a shared cancer follow‐up model of care between general practitioners and radiation oncologists: A qualitative evaluation. Health Expectations, 26(6), 2441-2452.
33. Shah, K. P., Khan, S. S., Baldridge, A. S., Grady, K. L., Cella, D., Goyal, P., . . . Ahmad, F. S. (2023). Health Status in Heart Failure and Cancer: Analysis of the Medicare Health Outcomes Survey 2016-2020. JACC: Heart Failure.
34. Shen, X., Spratt, D. E., Dusetzina, S. B., & Chen, R. C. (2023). Variations in Medical Necessity Determinations Across Commercial Insurance Carriers for Prostate Cancer Procedures. International Journal of Radiation Oncology* Biology* Physics, 115(1), 34-38.
35. Shieh, C., Hakam, N., Pearce, R. J., Nagpal, M., Ghaffar, U., Guzman, J. L., . . . Breyer, B. N. (2024). Conservative management of penile and urethral lichen sclerosis: a systematic review. The Journal of Urology, 211(3), 354-363.
36. Thorn, J. C., Turner, E. L., Walsh, E. I., Donovan, J. L., Neal, D. E., Hamdy, F. C., . . . Noble, S. M. (2023). Impact of P.S.A. testing on secondary care costs in England and Wales: estimates from the Cluster randomized trial of P.S.A. testing for Prostate cancer (C.A.P.). B.M.C. Health Services Research, 23(1), 1-11.
37. Townsend, J. S., Rohan, E. A., Sabatino, S. A., & Puckett, M. (2023). Use of cancer survivorship care guidelines by primary care providers in the United States. The Journal of the American Board of Family Medicine, 36(5), 789-802.
38. Usher-Smith, J. A., Hindmarch, S., French, D. P., Tischkowitz, M., Moorthie, S., Walter, F. M., . . . Taylor, L. (2023). Proactive breast cancer risk assessment in primary care: a review based on the principles of screening. British Journal of Cancer, 1-11.
39. Wang, C., Lu, H., Bowen, D. J., & Xuan, Z. (2023). Implementing digital systems to facilitate genetic testing for hereditary cancer syndromes: An observational study of 4 clinical workflows. Genetics in Medicine, 25(5), 100802.
40. Weiner, A. B., Agrawal, R., Valle, L. F., Sonni, I., Kishan, A. U., Rettig, M. B., . . . Reiter, R. E. (2024). Impact of PSMA PET on Prostate Cancer Management. Current Treatment Options in Oncology, 1-15.
41. Westerberg, M., Irenaeus, S., Garmo, H., Stattin, P., & Gedeborg, R. (2024). Development and validation of a multi-dimensional diagnosis-based comorbidity index that improves prediction of death in men with prostate cancer: Nationwide, population-based register study. PLoS ONE, 19(1), e0296804.
42. Yourman, L. C., Bergstrom, J., Bryant, E. A., Pollner, A., Moore, A. A., Schoenborn, N. L., & Schonberg, M. A. (2023). Variation in Receipt of Cancer Screening and Immunizations by 10-year Life Expectancy among U.S. Adults aged 65 or Older in 2019. Journal of General Internal Medicine, 1-10.
43. Zhang, Y., H., & Cai, H. (2023). Unmet Supportive Care Needs of Prostate Cancer Survivors in China: A Cross-Sectional Study. Advances in Education, Humanities and Social Science Research, 8(1), 229-229.