Prostate Cancer in Men Under 50: A Togolese Perspective from Sub-Saharan Africa

Background: Prostate cancer is a growing public health concern, as it is being diagnosed more frequently in men under the age of 50. While this cancer is typically associated with advanced age, usually over 60, it is increasingly affecting younger men. The purpose of this study was to provide a comprehensive overview of the epidemiological, clinical, and histopathological characteristics of prostate cancer in men under 50 years of age in Togo. Methods: It was a retrospective descriptive, cross sectional study of histologically confirmed cases of prostate cancer in young adults at the Pathological Laboratory of Lomé over a period of 10 years (2011-2020). Result: The study identified 29 cases of prostate cancer in men under 50, accounting for 0.7% of all prostate cancers. The average age of the patients was 45, ranging from 35 to 49. 12 of them had a family history of prostate cancer, and there was a statistically significant relationship between family history and age of onset (p-value = 0.03). The most common clinical presentation was prostatic hypertrophy (40.37%), followed by acute urine retention (20.69%) and micturition disorders (17.27%). The median Prostate Specific Antigen (PSA) was 188 ng/ml with a range of 20 ng/ml to 2100 ng/ml, with a large proportion of patients having PSA levels between 100 and 500 ng/ml. Histologically, all cases were identified as prostatic acinar adenocarcinomas, with 48% classified as well-differentiated and 38% as moderately differentiated. The predominant histoprognostic grade was ISUP grade 1, noted in 65.52% of cases, followed by grade 2 in 20.69%. Conclusion: The incidence of prostate cancer in men under the age of 50 is low in Togo and is often observed in individuals with a family history of the disease. Therefore, it is crucial to increase awareness among the male population, especially those with a family history of prostate cancer, to initiate screening at an early age, around 40 years