{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T07:04:15Z","timestamp":1784099055189,"version":"3.55.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prostate cancer is a common malignancy and major cause of cancer mortality among men worldwide. Early detection improves outcomes, but participation depends on awareness, perceived risk, and attitudes toward testing and diagnostic pathways. In Armenia, many cases are diagnosed at advanced stages, partly due to limited screening practices and low public awareness. This study assessed Armenian men\u2019s knowledge of prostate cancer, perception of personal risk, and attitudes toward prostate MRI within early-detection pathways, including perceived barriers to undergoing MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted from December 2024 to March 2025 at the Proton Diagnostic and Educational Center in Yerevan, Armenia. The study included 196 men aged \u226545\u202fyears undergoing MRI examinations unrelated to prostate conditions. Participants completed a structured 38-item questionnaire adapted from validated international surveys assessing awareness, perceived risk, screening attitudes, and barriers to MRI screening. Four perception scores were derived from Likert-scale responses. Associations between sociodemographic factors and perception scores were examined using multivariable linear regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean perceived risk score was 2.95 (SD\u202f=\u202f0.73) and the mean awareness score was 3.21 (SD\u202f=\u202f0.72). Men aged 56\u201365\u202fyears had a 0.30-point higher perceived risk than those aged 45\u201355\u202fyears (mean difference. = 0.30; 95% CI: 0.05\u20130.55). Awareness was 0.32 points lower among men with secondary education or less (mean difference\u202f=\u202f\u22120.32; 95% CI: \u22120.57 to \u22120.07). The mean screening confidence score was 3.45 (SD\u202f=\u202f0.81). Perceived barriers to MRI screening were higher among men with secondary education or less (mean difference\u202f=\u202f0.39; 95% CI: 0.18\u20130.60) and those with vocational or technical education (adjusted mean difference\u202f=\u202f0.40; 95% CI: 0.19\u20130.61) than among those with higher education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Awareness of prostate cancer and early detection among Armenian men moderate and varied by education level. Lower educational attainment was consistently associated with lower awareness and greater perceived barriers to MRI-based diagnostic evaluation. Targeted health education and more equitable access to diagnostic services may support earlier detection and help reduce the burden of prostate cancer in Armenia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1868400","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:05:00Z","timestamp":1784095500000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Awareness, risk perception, and attitudes toward prostate cancer detection and MRI among Armenian men"],"prefix":"10.3389","volume":"14","author":[{"given":"N. N.","family":"Shalunc","sequence":"first","affiliation":[{"name":"Faculty of Public Health, Yerevan State Medical University Named After Mkhitar Heratsi","place":["Yerevan, Armenia"]},{"name":"Proton Diagnostic and Educational Center","place":["Yerevan, Armenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. S.","family":"Gaboyan","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Diego","place":["La Jolla, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. G.","family":"Matinyan","sequence":"additional","affiliation":[{"name":"Proton Diagnostic and Educational Center","place":["Yerevan, Armenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. S.","family":"Mnatsakanyan","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Yerevan State Medical University Named After Mkhitar Heratsi","place":["Yerevan, Armenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. G.","family":"Hovhannisyan","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Yerevan State Medical University Named After Mkhitar Heratsi","place":["Yerevan, Armenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. J.","family":"Ergas","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California","place":["Pleasanton, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"ref1","volume-title":"Cancer Facts & Figures 2025","year":"2025"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1595159","DOI":"10.3389\/fpubh.2025.1595159","article-title":"Global, regional, and national prevalence of prostate cancer from 1990 to 2021: a trend and health inequality analyses","volume":"13","author":"Zhao","year":"2025","journal-title":"Front Public Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1553747","DOI":"10.3389\/fpubh.2025.1553747","article-title":"The global, regional, and national prostate cancer burden and trends from 1990 to 2021: results from the global burden of disease study 2021","volume":"13","author":"Liu","year":"2025","journal-title":"Front Public Health"},{"key":"ref4","year":"2022"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.eururo.2019.08.005","article-title":"Recent global patterns in prostate cancer incidence and mortality rates","volume":"77","author":"Culp","year":"2020","journal-title":"Eur Urol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.1016\/S0140-6736(24)00651-2","article-title":"The lancet commission on prostate cancer: planning for the surge in cases","volume":"403","author":"James","year":"2024","journal-title":"Lancet"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.eururo.2023.04.021","article-title":"2022 update on prostate cancer epidemiology and risk factors: a systematic review","volume":"84","author":"Bergengren","year":"2023","journal-title":"Eur Urol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1001\/jama.2025.0228","article-title":"Prostate cancer: a review","volume":"333","author":"Raychaudhuri","year":"2025","journal-title":"JAMA"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.21037\/tau-2025-103","article-title":"Global epidemiological trends in prostate cancer burden: a comprehensive analysis from global burden of disease study 2021","volume":"14","author":"Lin","year":"2025","journal-title":"Transl Androl Urol"},{"key":"ref11","year":"2025"},{"key":"ref12","volume-title":"Health Systems in action: Armenia 2024","year":"2024"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"782581","DOI":"10.3389\/fonc.2021.782581","article-title":"Overview of cancer control in Armenia and policy implications","volume":"11","author":"Bedirian","year":"2022","journal-title":"Front Oncol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1080\/14737140.2025.2483853","article-title":"Prostate cancer in central and Eastern Europe: a comprehensive regional analysis of burden, trends, and future projections based on the global burden of disease study (1990\u20132021)","volume":"25","author":"Satapathy","year":"2025","journal-title":"Expert Rev Anticancer Ther"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1016\/j.mcna.2020.08.007","article-title":"Screening for prostate cancer","volume":"104","author":"Carlsson","year":"2020","journal-title":"Med Clin North Am"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"54","DOI":"10.21037\/tau.2017.12.12","article-title":"What is an acceptable false negative rate in the detection of prostate cancer?","volume":"7","author":"Verbeek","year":"2018","journal-title":"Transl Androl Urol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.eururo.2024.03.027","article-title":"EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate cancer\u20142024 update. 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