Shahrekord University of Medical Sciences Epidemiology and Health System Journal 2980-7891 12 4 2025 12 30 Men’s Knowledge, Beliefs, and Behaviors on Prostate Cancer Screening in Sfax: A Cross-Sectional Study 207 216 10.34172/ehsj.26578 EN Fedi Ben Dhaou https://orcid.org/0009-0004-6298-2385 Maroua Trigui https://orcid.org/0000-0002-7741-7950 Ali Bensaad https://orcid.org/0009-0001-5387-0320 Iyed Guechaoui https://orcid.org/0009-0006-8925-0058 Zeineb Mallek https://orcid.org/0009-0002-4638-3919 Ghada Nasri https://orcid.org/0009-0009-6657-748X Emna Mziou https://orcid.org/0000-0003-2682-406X Mohamed Dabbebi https://orcid.org/0009-0009-7624-374X Mondher Kassis https://orcid.org/0000-0002-5823-5748 Bassem Abid https://orcid.org/0000-0002-5535-854X Journal Article 10.34172/ehsj.26578 2025 08 19 2025 12 14 Background and aims: Prostate cancer (PCa) is the second most common malignancy among Tunisian men, although screening uptake remains low due to limited awareness and cultural barriers. Thus, this study aimed to assess the levels of knowledge, attitudes, cultural beliefs, views, and screening behaviors related to PCa among men aged 40 and above in the Sfax region of Tunisia and to identify factors influencing these dimensions. Methods: A descriptive and analytical cross-sectional study was conducted in 2025 among 1,520 men using a structured questionnaire covering sociodemographic and clinical factors, knowledge of PCa, attitudes, cultural beliefs, views, and screening practices. The obtained data were entered, verified, and analyzed using SPSS 25. Ultimately, univariate tests and multivariate logistic regression were used for statistical analysis. Results: Based on the results, participants demonstrated low knowledge (n=922; 60.7%), negative attitudes (n=1304, 85.8%), and moderate cultural beliefs (n=869, 57.2%). Only 7.4% had ever undergone PCa screening (n=113), and 68.7% expressed a willingness to perform screening in the future (n=966). Moreover, screening uptake was significantly associated with high knowledge (OR=4.399, P<0.001), positive attitudes (OR=4.579, P<0.001), and weak cultural beliefs (OR=0.251, P<0.001). Finally, barriers included lack of symptoms (55.2%), financial constraints (47.3%), and low perceived risk (46.3%). Conclusion: Overall, PCa screening remains low in the Sfax region, driven by limited knowledge, negative attitudes, and influential cultural beliefs. In general, higher knowledge and positive attitudes increased screening uptake, while strong cultural beliefs reduced it. Accordingly, improving awareness and addressing cultural and financial barriers are essential to enhance early detection.