Racial Disparities in Assignments of Less Invasive Prostate Cancer Screening Tests

A new study by researchers in the Health Economics and Analytics Lab in the School of Economics at the Georgia Institute of Technology finds that Black, Hispanic, and Asian men whose results on a common prostate cancer screening test indicated a need for additional testing were less likely than their White counterparts to receive an increasingly used follow-up test that can eliminate the need for an invasive biopsy.

The study found that Black men were at least 23.6 percent less likely than their White counterparts to receive an MRI exam following a prostate-specific antigen (PSA) blood test, a common initial screening for men between the ages of 55 and 69. The study also found that Hispanic and Asian men with elevated PSA results were significantly less likely to be referred for MRI evaluation. While biopsies have long been the next treatment step for some men with elevated PSA results, prostate MRIs are increasingly being used to reduce the need for that invasive procedure.

While the reason for the disparities is beyond the scope of the paper, the results are nevertheless concerning, particularly in light of previous research that has shown disparities in how physicians treat patients of color when compared to their White patients, said Danny Hughes, professor in the School of Economics at Georgia Tech and a co-author of the study.

“We can’t say definitively if the reason Black, Hispanic, and Asian men did not receive this particular test is that physicians did not refer them for it, or if the patients opted themselves out of further testing,” Dr. Hughes said. “Regardless, these disparities do highlight the need to understand what is happening and how to ensure patients of all races and ethnicities receive the best possible care.”

The study was conducted as part of a long-term HEAL research collaboration between Dr. Hughes and Richard Duszak, a professor at Emory University’s School of Medicine. Former HEAL postdoctoral researcher Nino Abashidze, now of the University of Wyoming, Chad Stecher of Arizona State University, and Andrew B. Rosenkrantz of the NYU Langone Medical Center also collaborated on the project.

The full study, “Racial and Ethnic Disparities in the Use of Prostate Magnetic Resonance Imaging Following an Elevated Prostate-Specific Antigen Test,” was published on the website of JAMA Network Open. It may be accessed here.

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