PD40-06 DISPARITIES IN USE OF PREBIOPSY PROSTATE MAGNETIC RESONANCE IMAGING FOR MEDICARE-ELIGIBLE PROSTATE CANCER PATIENTS

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making IV (PD40)1 Apr 2020PD40-06 DISPARITIES IN USE OF PREBIOPSY PROSTATE MAGNETIC RESONANCE IMAGING FOR MEDICARE-ELIGIBLE PROSTATE CANCER PATIENTS Timothy Quinn*, Dattatraya Patil, Martin Sanda, David Howard, and Christopher Filson Timothy Quinn*Timothy Quinn* More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Martin SandaMartin Sanda More articles by this author , David HowardDavid Howard More articles by this author , and Christopher FilsonChristopher Filson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000920.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prebiopsy magnetic resonance imaging (MRI) of the prostate improves detection of significant tumors while decreasing detection of less aggressive tumors. We examined use of prebiopsy MRI among Medicare beneficiaries with prostate cancer. We hypothesized that patients of color and in more isolated areas would be less likely to undergo this approach of cancer detection. METHODS: Using SEER-Medicare claims, we identified men with non-metastatic prostate cancer from 2010–2015 with prostate-specific antigen (PSA) < 30 ng/mL. Outcome was prebiopsy prostate MRI within 6 months before diagnosis (i.e., CPT 72195–72197). Exposures were patient race/ethnicity and rural-urban status. We evaluated other factors including age, year of diagnosis, and PSA. Multivariable regression estimated odds of prebiopsy MRI based on race/ethnicity and rural-urban status. A post-hoc analysis assessed association with registry-level proportion of non-Hispanic Black (nHB) patients and disparities in MRI use based on race/ethnicity. RESULTS: We identified 50,719 men diagnosed with prostate cancer (mean age 72.1 years; mean PSA 8.0 ng/mL). The cohort was comprised of 10.5% nHB patients and 13.4% in a non-metropolitan area. Overall, 1,431 men (2.8% of cohort) had a prebiopsy MRI. Use of pre-biopsy MRI increased over time, with 576/8,201 (7.0%) men diagnosed in 2015 after a prebiopsy prostate MRI (p<0.001). Nearly three-fourths (1,055/1,431, 73.7%) of patients with a prebiopsy MRI were from California, New Jersey, or Connecticut. After adjusting for other factors, nHB men (1.0% vs 3.1% non-Hispanic White, OR 0.32, 95%CI 0.24–0.42) and men in less urban/rural areas (1.2% vs 3.3% large metro, OR 0.72, 95%CI 0.5 –0.99) were significantly less likely to have a prebiopsy prostate MRI. Disparities based on race/ethnicity persisted across all ranges of nHB representation at the registry level (Figure). CONCLUSIONS: Through 2015, use of prebiopsy prostate MRI for Medicare beneficiaries diagnosed with prostate cancer increased over time. Non-Hispanic Black and rurally located men were less likely to have a prebiopsy prostate MRI. If these disparities persist as use diffuses more widely, underserved populations may be at risk for suboptimal identification of clinically significant prostate cancer. Source of Funding: ACS MRSG for CPF © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e817-e817 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Timothy Quinn* More articles by this author Dattatraya Patil More articles by this author Martin Sanda More articles by this author David Howard More articles by this author Christopher Filson More articles by this author Expand All Advertisement PDF downloadLoading ...