PD40-03 RACIAL DISPARITIES IN MAGNETIC RESONANCE IMAGING-GUIDED BIOPSY FOR THE DIAGNOSIS OF PROSTATE CANCER IN THE UNITED STATES

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making IV (PD40)1 Apr 2020PD40-03 RACIAL DISPARITIES IN MAGNETIC RESONANCE IMAGING-GUIDED BIOPSY FOR THE DIAGNOSIS OF PROSTATE CANCER IN THE UNITED STATES Arveen Kalapara*, Bradly Watarai, Stephanie Jarosek, and Badrinath Konety Arveen Kalapara*Arveen Kalapara* More articles by this author , Bradly WataraiBradly Watarai More articles by this author , Stephanie JarosekStephanie Jarosek More articles by this author , and Badrinath KonetyBadrinath Konety More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000920.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiparametric magnetic resonance imaging (MRI) has evolved into an invaluable tool in the diagnostic pathway for localised prostate cancer. Racial disparities exist between Black and White American patients in treatment access and outcomes. However, it remains unclear whether any racial disparities exist in access to pre-biopsy prostate MRI. We aimed to compare rates of men undergoing MRI prior to prostate biopsy by race. METHODS: Retrospective review of a large de-identified commercial health insurance claims database in the United States (OptumLabs®) to identify men who underwent prostate biopsy and MRI between 2010 and 2017. Prostate biopsy was considered the index event and our cohort was restricted to men with continuous enrolment of 12 months prior and 1 month following biopsy. Race was classified as Black, White, Asian or Hispanic. Our primary outcome was utilization of MRI prior to prostate biopsy. We used Chi-square test to compare the proportion of men undergoing MRI in 2010 and 2017, and multivariable logistic regression adjusting for age, race and socioeconomic factors to predict likelihood of receiving MRI. RESULTS: We identified 108,557 patients who underwent prostate biopsy, including 86,997 White, 12,051 Black, 7220 Hispanic and 2289 Asian men. Median age was 64 years (IQR, 58-70). Overall, 134 of 18,584 (0.7%) men underwent MRI prior to biopsy in 2010, compared with 1828 of 11887 (15.4%) in 2017 (p<0.001). 0.68%, 0.70%, 1.02%, 1.65% compared to 15.1%, 10.1%, 23.4%, 21.7% White, Black, Hispanic, Asian men underwent MRI prior to biopsy in 2010 and 2017 respectively. On multivariable logistic regression, Black men were significantly less likely to receive MRI within 6 months prior to prostate biopsy than White men (OR 0.89, 95% CI 0.81-0.99). Hispanic men (OR 1.65, 1.50-1.81) and Asian men (OR 1.68, 1.43-1.97) were significantly more likely to receive MRI than White men. CONCLUSIONS: Among commercially insured men in the United States, Black men are significantly less likely, and Hispanic and Asian men significantly more likely, than White men to receive prostate MRI prior to biopsy. Further studies are required to identify reasons for these trends, and whether these persist in non-commercially insured patients. Source of Funding: Center for Healthy African American Men's Health through Partnerships (NIH U54MD008620) © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e815-e816 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arveen Kalapara* More articles by this author Bradly Watarai More articles by this author Stephanie Jarosek More articles by this author Badrinath Konety More articles by this author Expand All Advertisement PDF downloadLoading ...