Non-Hispanic Black (NHB) and Hispanic/Afro-Caribbean men have the highest risk for prostate cancer (PCa) compared to non-Hispanic White (NHW) men. However, ethnicity-specific outcomes of targeted fusion biopsy (FB) for the detection of PCa are poorly characterized. We compared the outcomes of FB by Prostate Imaging and Reporting Data System (PI-RADS) score and race/ethnicity among a diverse population.
We evaluated all men who underwent image-guided FB for suspicious lesions on prostate magnetic resonance imaging (MRI; ≥PI-RADS 3) over a two-year period. We examined associations of race/ethnicity and PI-RADS score with risk of PCa or clinically significant PCa (cs-PCa, Gleason group ≥2) on FB using mixed-effects logistic regression models.
Four-hundred-ten men with 658 lesions were analyzed; 201 (49.0%) men identified as NHB; 125 (30.5%) identified as Hispanic. NHB men had a two-fold increase in the odds of detecting cs-PCa (OR=2.7, p=0.045), while Hispanic men had similar odds of detecting cs-PCa, compared to NHW men. With regards to all PCa, NHB men had a similar increase in the odds of detecting all PCa (OR=2.4, p=0.050), which was borderline statistically significant, compared to NHW men, on FB. When we excluded men on active surveillance, NHB men had even stronger associations with detection of cs-PCa (OR=3.10, p=0.047) or all PCa (OR=2.77, p=0.032) compared to NHW men.
NHB men have a higher odds for overall PCa and cs-PCa on FB compared to NHW men. Further work may clarify differences per PI-RADS score. Clinicians should interpret prostate MRI lesions with more caution in NHB men.
The Journal of urology. 2021 Apr 21 [Epub ahead of print]
Laena Hines, Denzel Zhu, Matt DeMasi, Mustufa Babar, Victoria Chernyak, Evan Z Kovac, Ahmed Aboumohamed, Alex Sankin, Ilir Agalliu, Kara L Watts
Department of Urology, University of Rochester Medical Center, Rochester, New York., Albert Einstein College of Medicine, Bronx, New York.