Connor Hoge1, Sadhna Verma2, Daniel J Lama1, Ilana Bergelson1, Monzer Haj-Hamed1, Sean Maynor1, Krishnanath Gaitonde1, Abhinav Sidana3. 1. Division of Urology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 2. Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 3. Division of Urology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Abhinav.sidana@uc.edu.
Abstract
BACKGROUND: Black men have significantly higher incidence and are up to three times more likely to die of prostate cancer (PCa) than White men. Multiparametric magnetic resonance imaging-ultrasound fusion biopsy (FBx) has emerged as a promising modality for the detection of PCa. The goal of our study is to identify differences in utilization of FBx between Black and White men presenting with suspicion of PCa. METHODS: We performed a retrospective review of Black and White men who presented with suspicion of PCa and required biopsy from January 2014 to December 2018. Multivariate logistic regression analysis was done to study the influence of race on the utilization of FBx. RESULTS: Six hundred nineteen (Black: 182, White: 437) men were included in the study. Forty-one out of 182 (22.5%) Black men underwent FBx compared with 225/437 (51.5%) of White men (P < 0.001). After adjusting for age, race, prostate-specific antigen level, digital rectal exam, family history of PCa and health insurance provider, Black race was found to be a significant negative predictor of obtaining FBx (OR:0.32, 95% CI: 0.21-0.51, P < 0.001). Black race stayed an independent negative predictor (OR: 0.36, 95% CI: 0.20-0.64, P < 0.001) in the cohort of patients who were biopsy naïve; however, although reduced, there was no significant difference in the cohort with a prior negative biopsy (OR: 0.51, 95% CI: 0.19-1.36, P = 0.179). CONCLUSIONS: Although FBx is a superior modality for early detection of PCa, we found that Black men were less likely to undergo FBx when presenting with PCa suspicion. Further investigation is needed to evaluate if this difference is patient preference or if there are underlying socioeconomic, cultural or provider biases influencing this disparity.
BACKGROUND: Black men have significantly higher incidence and are up to three times more likely to die of prostate cancer (PCa) than White men. Multiparametric magnetic resonance imaging-ultrasound fusion biopsy (FBx) has emerged as a promising modality for the detection of PCa. The goal of our study is to identify differences in utilization of FBx between Black and White men presenting with suspicion of PCa. METHODS: We performed a retrospective review of Black and White men who presented with suspicion of PCa and required biopsy from January 2014 to December 2018. Multivariate logistic regression analysis was done to study the influence of race on the utilization of FBx. RESULTS: Six hundred nineteen (Black: 182, White: 437) men were included in the study. Forty-one out of 182 (22.5%) Black men underwent FBx compared with 225/437 (51.5%) of White men (P < 0.001). After adjusting for age, race, prostate-specific antigen level, digital rectal exam, family history of PCa and health insurance provider, Black race was found to be a significant negative predictor of obtaining FBx (OR:0.32, 95% CI: 0.21-0.51, P < 0.001). Black race stayed an independent negative predictor (OR: 0.36, 95% CI: 0.20-0.64, P < 0.001) in the cohort of patients who were biopsy naïve; however, although reduced, there was no significant difference in the cohort with a prior negative biopsy (OR: 0.51, 95% CI: 0.19-1.36, P = 0.179). CONCLUSIONS: Although FBx is a superior modality for early detection of PCa, we found that Black men were less likely to undergo FBx when presenting with PCa suspicion. Further investigation is needed to evaluate if this difference is patient preference or if there are underlying socioeconomic, cultural or provider biases influencing this disparity.
Authors: Andrew B Rosenkrantz; Sadhna Verma; Peter Choyke; Steven C Eberhardt; Scott E Eggener; Krishnanath Gaitonde; Masoom A Haider; Daniel J Margolis; Leonard S Marks; Peter Pinto; Geoffrey A Sonn; Samir S Taneja Journal: J Urol Date: 2016-06-16 Impact factor: 7.450
Authors: Marieke J Krimphove; Alexander P Cole; Sean A Fletcher; Sabrina S Harmouch; Sebastian Berg; Stuart R Lipsitz; Maxine Sun; Junaid Nabi; Paul L Nguyen; Jim C Hu; Adam S Kibel; Toni K Choueiri; Luis A Kluth; Quoc-Dien Trinh Journal: Prostate Cancer Prostatic Dis Date: 2018-08-31 Impact factor: 5.554
Authors: Chanita Hughes Halbert; Benita Weathers; Ernestine Delmoor; Brandon Mahler; James Coyne; Hayley S Thompson; Thomas Ten Have; David Vaughn; S Bruce Malkowicz; David Lee Journal: Cancer Date: 2009-06-01 Impact factor: 6.860
Authors: Soumitra S Bhuyan; Aastha Chandak; Niodita Gupta; Sudhir Isharwal; Chad LaGrange; Asos Mahmood; Dan Gentry Journal: Am J Mens Health Date: 2016-07-07
Authors: Natalie Escobio Bustillo; Heather L McGinty; Jason R Dahn; Betina Yanez; Michael H Antoni; Bruce R Kava; Frank J Penedo Journal: Psychooncology Date: 2015-11-09 Impact factor: 3.894
Authors: Mansi M Chandra; Seth H Greenspan; Xiaoning Li; Jie Yang; Aurora D Pryor; Annie Laurie Winkley Shroyer; John P Fitzgerald Journal: Am J Clin Exp Urol Date: 2021-12-15