African American Men have Increased Risk of Prostate Cancer Detection Despite Similar Rates of Anterior Prostatic Lesions and PI-RADS Grade on Multiparametric Magnetic Resonance Imaging.

Autor: Patel HD; Department of Urology, Loyola University Medical Center, Maywood, Illinois. Electronic address: hiten.patel@lumc.edu., Doshi CP; Department of Urology, Loyola University Medical Center, Maywood, Illinois., Koehne EL; Department of Urology, Loyola University Medical Center, Maywood, Illinois., Hart S; Minnesota Urology, St. Paul, Minnesota., Van Kuiken M; Department of Urology, University of California San Francisco, San Francisco, California., Quek ML; Department of Urology, Loyola University Medical Center, Maywood, Illinois., Flanigan RC; Department of Urology, Loyola University Medical Center, Maywood, Illinois., Gupta GN; Department of Urology, Loyola University Medical Center, Maywood, Illinois; Department of Surgery, Loyola University Medical Center, Maywood, Illinois; Department of Radiology, Loyola University Medical Center, Maywood, Illinois.
Jazyk: angličtina
Zdroj: Urology [Urology] 2022 May; Vol. 163, pp. 132-137. Date of Electronic Publication: 2021 Jul 21.
DOI: 10.1016/j.urology.2021.07.005
Abstrakt: Objective: To determine whether the frequency of anterior prostate lesions (APL) on multiparametric magnetic resonance imaging (mpMRI) prior to biopsy differed between African American (AA) and non-AA men and evaluate implications of race and tumor location for prostate cancer (PCa) detection.
Methods: Patients from the Prospective Loyola University mpMRI (PLUM) Prostate Biopsy Cohort (January 2015-December 2020) without prior diagnosis of PCa were evaluated for APLs by race. Multivariable logistic regression models evaluated predictors of APLs and associations of APLs and race with detection of any PCa (grade group 1+) and clinically significant PCa (csPCa; grade group 2+). Additional stratified and propensity score matched analyses were conducted.
Results: Of 1,239 men included, 190 (15.3%) were AA and 302 (24.4%) had at least one APL with no differences by race on multivariable analysis. While men with APLs were twice as likely to harbor PCa or csPCa, the unadjusted proportion of targeted biopsy-confirmed APL PCa (12.6% vs 12.0%) or csPCa (8.4% vs 8.9%) were similar for AA and non-AA men. AA men had higher risk of prostate cancer on targeted cores (OR 1.66 (95%CI 1.06 - 2.61), P = 0.026) which was independent of lesion location or PI-RADS.
Conclusion: AA men were found to have similar rates of APLs on mpMRI to non-AA men indicating access to mpMRI may mitigate some of the historical racial disparity based on lesion location. AA men have increased risk of PCa detection compared to non-AA men independent of anterior location or lesion grade on mpMRI reinforcing the importance of identifying genetic, biologic, and socioeconomic drivers.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: