Abstract

<p>Prostate cancer (PCa) is a significant global health concern, characterized by the abnormal and uncontrolled proliferation of cells in the prostate gland. As of 2020, there were an estimated 1.41 million newly diagnosed cases of prostate cancer worldwide, with an associated annual mortality of approximately 375,000 deaths. The global distribution of prostate cancer incidence varies widely, with the highest rates reported in Northern and Western Europe, the Caribbean, Australia/New Zealand, Northern America, and Southern Africa. Conversely, lower incidence rates are found in Asia and Northern Africa. Notably, mortality rates do not always mirror incidence patterns. Despite some regions having lower diagnosis rates, such as sub-Saharan Africa and the Caribbean, they experience disproportionately high mortality, highlighting disparities in healthcare systems, access to screening, and timely treatment. Micronesia/Polynesia, sub-Saharan Africa, and the Caribbean are particularly affected. The minimal expected global change in mortality, with a projected 1.05% increase, underscores the need for more targeted interventions to address screening and treatment inequities. Given these global trends, there is a pressing need to investigate the healthcare system factors that influence prostate cancer screening uptake, especially among high-risk populations such as African American men, who experience higher incidence and mortality rates. This systematic review aims to explore the healthcare system determinants that impact prostate cancer screening behaviors in this population and to identify opportunities for intervention that can reduce existing disparities and improve outcomes.</p>