FAMILIAL RISK FACTORS IN THE PROGRESSION OF PROSTATE CANCER IN NORTH AND SOUTH WAZIRISTAN: AN EPIDEMIOLOGICAL ASSESSMENT

Abstract

Prostate cancer ranks as the second most often diagnosed malignancy and is a primary cause of cancer-related death in men globally. Despite its growing prevalence in Pakistan, thorough regional data on its epidemiology continues to be limited. This research sought to examine the prevalence, risk factors, and age-specific distribution of prostate cancer in males residing in the tribal areas of North and South Waziristan, Pakistan. A cross-sectional, population-based epidemiological study was carried out with 1,330 male participants aged 40 years and older. Participants were selected using a multiple-stage random sampling method in both urban and rural environments. Prostate-specific antigen (PSA) testing was conducted, and those with high PSA values (>4.0 ng/mL) were referred for further clinical assessment and staging. Data about socio-demographic factors, lifestyle choices, familial history, and healthcare access were obtained using standardized questionnaires. Statistical studies, including chi-square tests and multivariate logistic regression, were conducted using SPSS Version 25. The overall prevalence of prostate cancer was 8.7%, with a gradual rise across older age cohorts. The greatest carry was seen in people aged 60–69 years (14.2%) and those aged 70 years and above (11.5%). Significant risk factors correlated with heightened prostate cancer risk encompassed advanced age (OR = 5.52, 60–69 years), absence of formal education (OR = 2.19), agricultural occupation (OR = 2.22), obesity (OR = 2.94), tobacco consumption (OR = 1.78), positive familial history (OR = 2.41), and restricted access to healthcare services (OR = 2.17). Regional inequalities were observed, with North Waziristan displaying elevated risk profiles, especially among people aged 60 years and older. Increased PSA levels, verified cancers, and advanced-stage diagnoses exhibited a pronounced age-dependent trend, suggesting the importance of age-specific screening strategies. The results support focused public health initiatives, such as awareness campaigns, early detection methods, and enhanced healthcare infrastructure to alleviate the effects of prostate cancer in underserved tribal regions of Pakistan.