Barriers to colorectal cancer screening in Ghana: a qualitative study of patients and physicians.

PURPOSE: The incidence of colorectal cancer (CRC) in Ghana has increased eightfold since the 1960s. In 2011, national guidelines were set forth recommending all patients aged 50-70 years old undergo annual CRC screening with fecal occult blood testing (FOBT), but adherence to these guidelines is poor and screening rates remain low for unclear reasons. METHODS: We performed semi-structured interviews with 28 Ghanaians including physicians (n = 14) and patients (n = 14) from the Komfo Anokye Teaching Hospital in Kumasi, Ghana, to better understand the factors driving screening adherence and perceived barriers identified in an earlier quantitative study. RESULTS: Participants reported sociocultural factors such as reliance on alternative medicine or religion, lack of education, and financial burden as community-level barriers to CRC screening. At the system level, screening was limited by insufficient access to FOBT as well as a perceived lack of national prioritization. This was described as inadequate efforts from the Ministry of Health regarding national education as well as lack of incorporation of CRC screening into the National Health Insurance Scheme. CONCLUSION: Several community- and system-level barriers exist to widespread screening of CRC in Ghana. A multi-level approach will be required to improve rates of CRC screening and ultimately reduce the burden of CRC in Ghana.

Prevalence of male sexual dysfunction among Ghanaian populace: myth or reality?

This study was designed to investigate the prevalence and type of sexual dysfunction (SD) in healthy sexually active Ghanaian men of fertile age. Sexual functioning was determined in 300 healthy Ghanaian men with the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire leaving in Kumasi metropolis, between December 2009 and April 2010. All men had a steady heterosexual relationship for at least 2 years before enrollment in the study. Of the 300 men selected, 255 (85%) completed the survey; the overall prevalence of SD in these subjects was 66%. The most prevalent areas of difficulty were infrequency (70.2%), premature ejaculation (64.7%), dissatisfaction with sexual acts (61.2%), impotency (59.6%), nonsensuality (59.2%), noncommunication (56.9%) and avoidance (49.0%). There were positive correlation between SD, impotence, dissatisfaction and age. The prevalence rate of SD in Ghanaian men is high and related to age.