To evaluate whether racial disparities in MRI-Bx usage persisted after correction for socioeconomic, demographic, and clinical factors.
This is a retrospective cohort study of patients who received either MRI-Bx or systematic biopsy (SB) within a single academic medical center between January 2018 - June 2020. For each patient, socioeconomic variables including household income, education, percent below poverty, and unemployment were estimated using 2015 American Community Survey census-tract level data. Chi-square analysis was used to examine differences in clinical and demographic characteristics between the two groups. The Benjamini-Hochberg procedure was used to control false discovery rate (FDR) for multiple testing.
Eighteen percent of Black men (53/295) received MRI-Bx while 41% (228/561) of white men received MRI-Bx. Patients coming from highly impoverished areas were less likely to receive MRI-Bx, 25% versus 75%, respectively. In multivariate analysis, race remained significantly different across MRI-Bx and SB groups. Clinical factors including family history, DRE, BMI, and prostate volume were not significantly different between patients receiving MRI-Bx and SB.
Black men are less likely to receive MRI-Bx than white men, even after adjusting for clinical and socioeconomic characteristics. Further work is necessary to identify and study methods to increase equity in PCa diagnostic testing.
Urology. 2022 Jan 04 [Epub ahead of print]
Emily Roebuck, Wei Sha, Caroline Lu, Caroline Miller, Earle Burgess, Claud Grigg, Jason Zhu, Kris E Gaston, Stephen Riggs, Justin T Matulay, Peter E Clark, James Kearns
Department of Urology, Levine Cancer Institute/Atrium Health, Charlotte, NC., Department of Cancer Biostatistics, Levine Cancer Institute/Atrium Health, Charlotte, NC., Department of Medical Oncology, Levine Cancer Institute/Atrium Health, Charlotte, NC., Department of Urology, Levine Cancer Institute/Atrium Health, Charlotte, NC. Electronic address: .