ABSTRACT
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.
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Article info
Publication history
Published online: July 20, 2021
Accepted:
July 8,
2021
Received:
March 30,
2021
Footnotes
Efforts to support data extraction and maintenance of The Prospective Loyola University mpMRI Prostate Biopsy Cohort database is supported by funding from Siemens Medical Solutions USA, Inc.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
