Department of Urology, Levine Cancer Institute/Atrium Health, Charlotte, NC.
Department of Cancer Biostatistics, Levine Cancer Institute/Atrium Health, Charlotte, NC.
Urology. 2022 May;163:156-163. doi: 10.1016/j.urology.2021.11.040. Epub 2022 Jan 5.
To evaluate whether racial disparities in MRI-Bx usage persisted after correction for socioeconomic, demographic, and clinical factors.
This is a retrospective cohort study of patients who received either MRI-Bx or systematic biopsy (SB) within a single academic medical center between January 2018 - June 2020. For each patient, socioeconomic variables including household income, education, percent below poverty, and unemployment were estimated using 2015 American Community Survey census-tract level data. Chi-square analysis was used to examine differences in clinical and demographic characteristics between the two groups. The Benjamini-Hochberg procedure was used to control false discovery rate (FDR) for multiple testing.
Eighteen percent of Black men (53/295) received MRI-Bx while 41% (228/561) of white men received MRI-Bx. Patients coming from highly impoverished areas were less likely to receive MRI-Bx, 25% vs 75%, respectively. In multivariate analysis, race remained significantly different across MRI-Bx and SB groups. Clinical factors including family history, DRE, BMI, and prostate volume were not significantly different between patients receiving MRI-Bx and SB.
Black men are less likely to receive MRI-Bx than white men, even after adjusting for clinical and socioeconomic characteristics. Further work is necessary to identify and study methods to increase equity in PCa diagnostic testing.
评估在纠正社会经济、人口统计学和临床因素后，MRI-Bx 使用的种族差异是否仍然存在。
这是一项回顾性队列研究，纳入了 2018 年 1 月至 2020 年 6 月期间在单一学术医疗中心接受 MRI-Bx 或系统活检（SB）的患者。对于每位患者，使用 2015 年美国社区调查普查区水平数据估计了社会经济变量，包括家庭收入、教育程度、贫困率和失业率。卡方分析用于检查两组之间临床和人口统计学特征的差异。Benjamini-Hochberg 程序用于控制多重检验的假发现率（FDR）。
18%的黑人男性（53/295）接受了 MRI-Bx，而 41%的白人男性（228/561）接受了 MRI-Bx。来自极度贫困地区的患者接受 MRI-Bx 的可能性较小，分别为 25%和 75%。在多变量分析中，种族在 MRI-Bx 和 SB 组之间仍然存在显著差异。临床因素，包括家族史、DRE、BMI 和前列腺体积，在接受 MRI-Bx 和 SB 的患者之间没有显著差异。
即使在调整了临床和社会经济特征后，黑人男性接受 MRI-Bx 的可能性也低于白人男性。需要进一步努力确定并研究增加前列腺癌诊断检测公平性的方法。
