Prostate Cancer Screening in Somalia: A Perspective on Addressing a Critical Gap in Early Detection

Prostate cancer is one of the leading cancers affecting men worldwide, with a growing burden in sub-Saharan Africa where mortality-to-incidence ratios remain among the highest globally. In many countries within the region, a substantial proportion of patients present with advanced-stage disease, reflecting limited access to early detection and diagnostic services, and despite the demonstrated benefits of screening, these gains have not been equitably realized in low-resource settings. In Somalia, prostate cancer screening is largely absent, contributing to late-stage diagnosis and poor clinical outcomes. This perspective highlights the importance of early detection and examines the structural, clinical, and socio-cultural factors underlying screening gaps in the Somali context, including the absence of national screening policies, limited access to prostate-specific antigen testing, underutilization of digital rectal examination, workforce shortages, and weak diagnostic referral pathways. Drawing on regional evidence and emerging local data, this article proposes pragmatic, context-appropriate strategies to improve early detection within fragile health systems, emphasizing that strengthening prostate cancer screening in Somalia through feasible, primary care–based interventions is essential to reduce preventable morbidity, improve survival outcomes, and advance equity in men’s health.