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.

中文翻译：

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使用多参数 MRI-超声融合活检检测前列腺癌的种族差异

背景

黑人男性的发病率明显更高，死于前列腺癌 (PCa) 的可能性是白人男性的三倍。多参数磁共振成像-超声融合活检 (FBx) 已成为检测 PCa 的一种有前途的方式。我们研究的目的是确定怀疑 PCa 的黑人和白人男性在使用 FBx 方面的差异。

方法

我们对 2014 年 1 月至 2018 年 12 月怀疑 PCa 并需要活检的黑人和白人男性进行了回顾性研究。进行了多变量逻辑回归分析以研究种族对 FBx 使用的影响。

结果

619 名（黑人：182，白人：437）男性被纳入研究。182 名黑人男性中有 41 名 (22.5%) 接受了 FBx，而白人男性中有 225/437 (51.5%) ( P  < 0.001)。在调整年龄、种族、前列腺特异性抗原水平、直肠指检、PCa 家族史和健康保险提供者后，发现黑人是获得 FBx 的显着负预测因子（OR：0.32，95% CI：0.21– 0.51，P  < 0.001）。在未 进行活检的患者队列中，黑人仍然是一个独立的阴性预测因子（OR：0.36，95% CI：0.20–0.64，P < 0.001）；然而，虽然减少了，但在先前活检阴性的队列中没有显着差异（OR：0.51，95% CI：0.19–1.36，P  = 0.179）。

结论

尽管 FBx 是早期检测 PCa 的优越方式，但我们发现黑人男性在怀疑 PCa 时不太可能接受 FBx。需要进一步调查来评估这种差异是否是患者的偏好，或者是否存在影响这种差异的潜在社会经济、文化或提供者偏见。