Prostate cancer is the second-leading cause of cancer deaths in American men. Further, non-Hispanic Blacks have a higher incidence of prostate cancer and are more likely to die from it than are non-Hispanic whites. A biopsy is recommended if a patient has certain risk factors like age, family history, symptoms and screening test results. When the biopsy sample is taken, physicians use either ultrasound or magnetic resonance imaging (MRI) to guide the procedure.
In a new study , researchers at Thomas Jefferson University combed through one of the largest cancer databases to assess the use of MRI in diagnosing prostate cancer from 2012 - 2019 and whether this choice contributes to disparities in cancer care.
"According to clinical guidelines, MRI is better at identifying cancers and has been increasingly used over the past decade," says Christiane El Khoury, PharmD , assistant director of cancer research administration at Jefferson and first author of the study. Studies have found that MRI-guided biopsies reduce the number of future biopsies a patient may undergo. However, the technology is more costly and may incur more out-of-pocket expenses.
Dr. El Khoury and her colleagues at the Sidney Kimmel Comprehensive Cancer Center - Jefferson Health found that there continues to be a gap in MRI use between Black and white patients. The good news is that the gap was halved in 2019 when it was about 20% compared to 2012, when it was 43%.
However, other disparities persist. Rural patients are 35% less likely than urban patients to have used MRI diagnostics, and that gap was relatively stable over the study period. In addition, the study identified regional differences, with far less MRI use in South and Central U.S. compared to the West. The research team, led by Grace Lu-Yao, PhD , population science researcher and professor at Sidney Kimmel Comprehensive Cancer Center - Jefferson Health – Jefferson Health, plans to dig more deeply into geographic disparities to look for clusters of high or low utilization.
"We're passionate about this research: finding drivers of disparities," Dr. El Khoury says, adding that the hope is to enhance access to MRI and potentially improve prostate cancer outcomes.
By Jill Adams
