Prostate cancer: Why South African men need to screen early

September marks Prostate Cancer Awareness Month, with health organisations urging South African men to understand their risk and prioritise early detection.

September marks Prostate Cancer Awareness Month, with health organisations urging South African men to understand their risk and prioritise early detection.

Despite the growing incidence of the disease, awareness about prostate cancer remains low among many South African men.

A 2023 study among Black men diagnosed with prostate cancer in the Free State found that fewer than one in four had heard of the disease before their diagnosis.

Another study, conducted among men in Limpopo in 2023, found that almost two-thirds had inadequate awareness of prostate cancer, while more than 80% did not know screening methods.

The risk is particularly significant for South African men. One in four Black men and one in eight white men will be diagnosed with prostate cancer during their lifetime.

Black African men face a 60% higher risk of developing prostate cancer than white men and are 2.5 times more likely to die from the disease.

Andrew Oberholzer, CEO of the Prostate Cancer Foundation of South Africa, said Black African men were also more prone to developing an aggressive form of prostate cancer than Black American men.

Studies across Africa are investigating genetic factors that could help explain the increased risk.

According to Globocan, the specialised cancer research agency of the World Health Organization, prostate cancer is now the most common cancer in South Africa and the second most deadly cancer among South African men after lung cancer.

When prostate cancer is detected and treated before it spreads beyond the prostate, more than 99% of men are still alive five years after diagnosis.

However, a 2026 South African study by researchers from Walter Sisulu University found that late presentation remains a widespread challenge, highlighting gaps in early detection, delayed referrals and limited access to PSA testing.

PSA, or prostate-specific antigen, is a protein produced by the prostate. A blood test can measure PSA levels and help detect prostate cancer. An elevated PSA level may require further investigation and referral to a urologist.

“Feeling healthy doesn’t necessarily mean that prostate cancer isn’t there, as the disease often develops without noticeable symptoms in its early stages,” Oberholzer said.

“Regular, age and risk appropriate PSA screening gives men a better chance of finding the disease early, when treatments are a potentially curable and outcomes are generally far better.”

Prostate cancer starts in the prostate, a small gland located just below the bladder.

Early prostate cancer usually causes no symptoms, while advanced disease can include difficulty urinating, blood in the urine or semen, erectile dysfunction, bone pain, weakness or numbness in the legs or feet, unexplained weight loss and persistent fatigue.

The risk increases with age and is also higher among men with close relatives, particularly a father or brother, who have had prostate cancer. The younger the relative was when diagnosed, the higher the risk.

A family history of breast cancer is also associated with increased prostate cancer risk, while inherited genetic factors are estimated to account for up to 57% of a man's susceptibility to developing the disease.

Men considered at higher risk are recommended to have annual PSA screening from age 40, while men at average risk should start screening at 45.

Initiatives such as the Prostate Cancer Foundation's Suit Up September campaign and the annual Hollard Daredevil Run aim to encourage more South African men to talk about prostate cancer, understand their risk and consider screening.

This year's Hollard Daredevil Run takes place on October 23, with funds raised supporting the Prostate Cancer Foundation and the Cancer Association of South Africa (CANSA).

The funds help raise awareness about prostate and testicular cancers and extend PSA screening to communities where access remains limited.

“There are too many South African men who still know too little about prostate cancer, their personal risk and the importance of getting screened. We need to keep changing that conversation,” said Hollard South Africa's Head of Experiential Marketing, Adél Kriel.

The Prostate Cancer Foundation has also announced that the first comprehensive Prostate Cancer Registry is being developed in partnership with non-profit data analysis organisation Health Quality Assessment and various medical professional societies.

Oberholzer's message to South African men is straightforward: “Don’t wait for symptoms.”

He urged men to understand their risk, speak to a healthcare provider or local clinic and get screened, noting that early detection can save lives.

For more information and registration details about the 2026 Hollard Daredevil Run, go to https://www.hollard.co.za/daredevilrun. For more information about the Prostate Cancer go to https://prostate-ca.co.za/ and https://cansa.org.za/prostate-cancer/.