You have accessJournal of UrologyCME1 Apr 2023MP12-18 RACIAL DISPARITY IN PROSTATE CANCER DIAGNOSIS: A COMPARISON OF PROSTATE BIOPSY RESULTS IN AFRICAN AMERICAN AND WHITE MEN USING AN MRI-BASED BIOPSY STRATEGY. Ali Kasraeian, Miguel Alcantara, Kaitlyn Mola Alcantara, Adam Brochert, Joshua Yellin, Eliana Namen, Sean Parsons, Jamie Cesaretti, and Ahmad Kasraeian Ali KasraeianAli Kasraeian More articles by this author , Miguel AlcantaraMiguel Alcantara More articles by this author , Kaitlyn Mola AlcantaraKaitlyn Mola Alcantara More articles by this author , Adam BrochertAdam Brochert More articles by this author , Joshua YellinJoshua Yellin More articles by this author , Eliana NamenEliana Namen More articles by this author , Sean ParsonsSean Parsons More articles by this author , Jamie CesarettiJamie Cesaretti More articles by this author , and Ahmad KasraeianAhmad Kasraeian More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003227.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: African American (AA) men in the United States have an increased burden of morbidity and mortality from prostate cancer (PCa). The roles of factors related to both racial disparities and intrinsic biological traits remain to be determined. We quarried our prospective database of standard and MRI fusion prostate biopsies (tMRI/US FPB) to determine if any pre-biopsy characteristics predicted adverse tumor pathology. METHODS: Between January 2017 and September 2022, 828 men underwent prostate biopsy (PBx) using an MRI-based algorithm. Men with negative MRI underwent standard PBx (n=440), while those with lesion on mpMRI underwent tMRI/US FPB (n=388). All patients underwent mpMRI of the prostate, interpreted by a single radiologist using the PIRADS scoring system. 3D rendering of the regions of interest was performed by the radiologist prior to tMRI/US FPB performed by a single urologist using the Invivo UroNav Fusion Biopsy System. A standard 14-core PBx was performed at the same time in all tMRI/US FPB cases. Prospective data was collected and analyzed. RESULTS: Of the 828 men who underwent standard and tMRI/US FP with 14Bx (tMRI/US FP-14Bx), 593 presented with a rise in PSA, while 235 had a suspicious digital rectal exam. Prostate Cancer was found in 367/608 (60%) of the White men and 104/147 (70.8%) of AA men in our series (p=0.02). 224/608 (36.8%) of White men and 74/147 (50.3%) of AA men had a Gleason score of 7-10 (p=0.003). Age, DRE status, PIRADS score, and the incidence of Gleason 6 PCa were not found to be significantly different by race. 163/608 (26.8%) of White men and 20/147 (13.6%) of AA men had a PSA upon presentation of 0-3.9 ng/ml (p=0.001). The PSA levels of 4.0-9.9 ng/ml and PSA > 10 ng/ml at presentation were not significantly different. Of the 73/828 (8.8%) of men who identify as not White and not Black no significant difference was found for any tested factor but interestingly 19/73 (26%) presented with a PSA between 0-3.9 ng/ml versus Black men (p=0.02) which was almost identical to the effect seen relative to White men. CONCLUSIONS: In this dataset, it appears that AA men present with a higher PSA than White men. It is likely that this is related to disparities in access to care rather than biological intrinsic factors. Also, we did observe a higher incidence of Gleason 7-10 PCa in AA men, which one would expect in a cohort of patients who presented for biopsy in the community with a significantly higher PSA at initial presentation. Continuing education of primary care providers regarding the importance of PSA testing in the AA community should be emphasized by both the urological and primary care professional medical societies. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e140 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ali Kasraeian More articles by this author Miguel Alcantara More articles by this author Kaitlyn Mola Alcantara More articles by this author Adam Brochert More articles by this author Joshua Yellin More articles by this author Eliana Namen More articles by this author Sean Parsons More articles by this author Jamie Cesaretti More articles by this author Ahmad Kasraeian More articles by this author Expand All Advertisement PDF downloadLoading ...
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