Black Men Less Likely to Get Follow-Up MRI

By Robert Preidt
Health Day reporter

WEDNESDAY, Nov. 10, 2021 (HealthDay News) – Black, Hispanic and Asian men in the United States are less likely than white men to receive follow-up MRIs after screening suggests prostate cancer, new study finds .

“We can’t say for sure if the reason black, Hispanic and Asian men didn’t receive this particular test is because the doctors didn’t refer them for it, or if the patients chose not to have it. other tests, ”said study author Danny Hughes. , professor at the Georgia Tech College of Liberal Arts School of Economics, in Atlanta.

“Either way, these disparities highlight the need to understand what is going on and how to ensure that patients of all races and ethnicities receive the best possible care,” Hughes said in an academic press release.

A prostate specific antigen (PSA) test is a common form of screening for prostate cancer in men aged 55 to 69. Biopsies have been the usual next step for some men with high PSA levels that suggest prostate cancer, but non-invasive MRIs are increasingly used instead.

To assess racial differences in the use of follow-up MRI tests, researchers analyzed nearly 795,000 insurance claims from 50 states for PSA tests that included lab results. They then looked at how many men had received a follow-up MRI based on different PSA levels.

A PSA result of 4 ng / mL has long been considered the cutoff to recommend a prostate biopsy; 2.5 ng / mL is a more recently recognized level for the early detection of prostate cancer; and 10 ng / mL are associated with higher rates of biopsies and cancer diagnoses.

Compared to white men, black men aged 40 to 54 with PSA greater than 4 ng / mL were about 40% less likely to have an MRI of the prostate, while black men aged 65 to 74 with a PSA greater than 4 ng / mL were 24% less. likely. And black patients aged 65 to 74 with PSA greater than 10 ng / mL were 44% less likely, according to the results.

Compared with white patients, Asian men aged 55 to 64 with PSA greater than 2.5 ng / mL were 57% less likely to receive an MRI of the prostate, and Asians with scores greater than 4 ng / mL were 63% less likely.

Likewise, Hispanic men aged 55 to 64 with PSA greater than 10 ng / mL were 68% less likely to have follow-up MRI compared to white men, according to the study.

The results were published online on November 8 in JAMA network open.

The study’s authors said their findings are of particular concern because of the increased risk of prostate cancer in black men. Previous research has shown that black people are more likely to contract the disease, often contract it earlier in life, and are more likely to die from it.

“We need to better understand the role of decision bias among physicians, as well as other potential factors in the healthcare system that could explain the disparities we see in this study,” said Hughes.

More information

The American College of Radiology and the Radiological Society of North America have more information on MRI of the prostate.

SOURCE: Georgia Institute of Technology, press release, November 8, 2021

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