Molecular And Sociobehavioral Determinants Of Cancer Risk Among Middle-Aged Men In Cameroon: A Mixed-Methods Study

Abstract

Introduction: Cancer incidence and mortality are increasing across sub-Saharan Africa, yet the determinants of cancer vulnerability among men remain insufficiently characterised, particularly where molecular risk pathways intersect with behavioural and sociocultural influences. In Cameroon, middle-aged men may experience heightened exposure to carcinogenic risks through lifestyle patterns, infection-related oncogenesis, and structural constraints that delay prevention and early detection. However, evidence integrating molecular biomarkers with lived experiences and health-seeking behaviours is limited. This study investigated the molecular and sociobehavioural determinants of cancer risk among men aged 30–60 years in Cameroon using a mixed-methods approach.

Methods: A mixed-methods explanatory sequential design was employed. Quantitative data were collected from 60 men, including plasma and saliva biomarkers (oxidative stress: MDA, 8-OHdG; inflammatory cytokines: IL-6, TNF-α; viral oncogenesis: high-risk HPV, HBsAg) and lifestyle surveys (tobacco, alcohol, diet, physical activity). Qualitative data were obtained through 20 in-depth interviews and two focus group discussions exploring perceptions of cancer, masculinity, and health-seeking behaviors. Quantitative data were analyzed descriptively and stratified by age, residence, and education, while qualitative data were thematically analyzed. Integrated interpretation used joint displays to triangulate findings.

Results: Biomarker analysis revealed elevated oxidative stress in 70% of participants, DNA damage in 58.3%, and systemic inflammation in 45% (IL-6) and 38.3% (TNF-α). High-risk HPV was detected in 25%, and HBsAg in 16.7%. Lifestyle risk factors were widespread: hazardous alcohol consumption (65%), smoking (33.3%), low fruit/vegetable intake (46.7%), and physical inactivity (40%). Qualitative narratives highlighted cultural norms of masculinity, fatalistic beliefs about cancer, stigma, and financial and structural barriers to screening. Integration revealed that elevated biomarker levels often coincided with risky behaviors and sociocultural constraints, suggesting a multifactorial risk profile.

Conclusion: Middle-aged Cameroonian men exhibit a confluence of biological, behavioral, and sociocultural determinants that increase cancer susceptibility. Effective prevention requires integrative strategies combining molecular screening, culturally tailored health education, and structural interventions to improve access to early detection and reduce risk behaviors. Addressing these intersecting factors is essential for mitigating the cancer burden and advancing context-specific carcinogenesis research in sub-Saharan Africa.