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Black men are less likely to get follow-up MRI

By Robert Preidt
HealthDay Reporter

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

“We can not say definitively whether the reason black, Hispanic and Asian men did not receive this particular test is because doctors did not refer them for it, or if the patients refused themselves further testing,” study author Danny said. Hughes said. , a professor at the Georgia Tech College of Liberal Arts School of Economics, in Atlanta.

“Regardless, these inequalities do emphasize the need to understand what is happening and how to ensure that patients of all races and ethnicities receive the best possible care,” Hughes said in a university news release.

A prostate-specific antigen (PSA) test is a common form of screening for prostate cancer in men aged 55 to 69. Biopsies were the usual next step for some men with elevated PSA levels suggesting prostate cancer, but non-invasive MRIs are increasingly being used sooner.

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

A PSA result of 4 ng / ml has long been considered the threshold for the recommendation of prostate biopsy; 2.5 ng / ml is a more recently recognized level for early detection of prostate cancer; and 10 ng / ml are associated with higher rates of biopsies and cancer diagnosis.

Compared to white men, black men aged 40 to 54 years with a PSA above 4 ng / ml were approximately 40% less likely to have a prostate MRI, whereas black men aged 65 to 74 with a PSA above 4 ng / ml was 24% less. probably. And black patients aged 65 to 74 with a PSA above 10 ng / ml were 44% less likely, the findings showed.

Compared to white patients, Asian men aged 55 to 64 with a PSA above 2.5 ng / ml were 57% less likely to receive a prostate MRI, and Asians with scores above 4 ng / ml were 63% less likely.

Similarly, Spanish men aged 55 to 64 with a PSA above 10 ng / ml were 68% less likely to receive the MRI follow-up compared to white men, according to the study.

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

The study authors said their results are particularly worrying due to the increased risk of prostate cancer in black men. Previous research has shown that black people are more likely to get the disease, often get it earlier in life and more likely to die from it.

“We need to understand more about the role of decision biases in physicians, as well as other potential factors in the health care system that may be responsible for the inequalities we see in this study,” Hughes said.

More information

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

SOURCE: Georgia Institute of Technology, news release, Nov. 8 2021

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