Asian, Black, and Hispanic patients with elevated prostate-specific antigen (PSA) levels are less likely than their White counterparts to undergo prostate MRI, according to a study published in JAMA Network Open.

For this retrospective study, researchers examined medical insurance claims for 794,809 patients, made between January 2011 and December 2017.

All patients had received a single PSA test result. They did not have prior PSA tests or MRI imaging, nor did they have additional PSA tests during the study period.

The patients’ mean age was 59.8 years (range, 40-89 years). Most patients (57.3%) were White, 13.6% were Hispanic, 9.6% were Black, and 3.9% were Asian.

There was no significant association between race/ethnicity and the mean time between a PSA test and subsequent prostate MRI.

However, Asian, Black, and Hispanic patients with elevated PSA levels were all less likely to undergo a prostate MRI within 180 days of their PSA test, when compared with White patients.

Black patients with PSA levels above 4 ng/mL were 24.1% less likely than their White counterparts to undergo a prostate MRI (odds ratio [OR], 0.76; 95% CI, 0.65-0.89). Black patients with PSA levels above 10 ng/mL were 35% less likely to undergo a prostate MRI (OR, 0.65; 95% CI, 0.50-0.85).

Asian patients with PSA levels above 2.5 ng/mL were 26.7% less likely than their White counterparts to undergo a prostate MRI (OR, 0.73; 95%CI, 0.57-0.95). And Asian patients with PSA levels greater than 4 ng/mL were 24.1% less likely to undergo a prostate MRI (OR, 0.76; 95% CI, 0.58-0.99).

Hispanic patients with PSA levels above 10 ng/mL were 23.4% less likely than their White counterparts to undergo a prostate MRI (OR, 0.77; 95% CI, 0.59-0.99).

These results support previous research showing ethnic and racial disparities in prostate cancer care and diagnosis, according to the researchers.

“[C]lear guidelines on the use of prostate MRI in prostate cancer detection may help to standardize the evaluation for prostate cancer across all patients,” the researchers wrote.

Reference

Abashidze N, Stecher C, Rosenkrantz AB, Duszak R, Hughes DR. Racial and ethnic disparities in the use of prostate magnetic resonance imaging following an elevated prostate-specific antigen test. JAMA Netw Open. Published online November 8, 2021. doi:10.1001/jamanetworkopen.2021.32388