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.