Study Highlights Racial Disparities in Prostate Cancer Imaging Utilization

A new meta-analysis has revealed stark racial disparities in the use of imaging for men with suspected prostate cancer, raising concerns about unequal access to essential diagnostic tools and the resulting impact on patient outcomes.

The study, published in Current Problems in Diagnostic Radiology, found that Caucasian men are three times more likely to undergo prostate MRI than Black men. Disparities were even greater when comparing other minority groups. Researchers also reported lower utilization of transrectal ultrasound (TRUS) among Black men.

Lead author Ashkan Bahrami, MD, of Kashan University of Medical Science in Iran, and colleagues stressed the consequences of these inequities. “Racial disparities in diagnostic imaging, particularly the use of multiparametric MRI (mpMRI) for prostate cancer, are associated with poor outcomes for Black patients. Even after adjusting for age and disease stage, recent studies demonstrate that Black males are disproportionately less likely to receive mpMRI than white males, with socioeconomic, geographical, and insurance-specific factors accounting for more than 81% of the difference in mpMRI use,” they wrote.

The analysis encompassed 33 studies and more than 94,000 patient cases, spanning six racial categories: African-American/Black, White, Asian, Caucasian, Hispanic, and “other.” The mean age across patients was 77.9 years.

The findings were striking:

• 66% of White patients underwent prostate MRI.

• Only 19% of Black men received the same imaging.

• Utilization dropped further among other minority groups: 7% for Hispanic men, 4% for Asians, and 24% for the “other” group.

• Black men also demonstrated relatively low TRUS usage, at 30%.

Researchers noted that socioeconomic status played a significant role in imaging disparities. Patients with broader insurance coverage and higher incomes were far more likely to access advanced diagnostic tools. “Income and socioeconomic disparities are well-documented contributors to healthcare access inequities,” the authors explained. “For instance, patients with a broader variety of insurance coverage and better incomes are more likely to seek advanced diagnostic imaging.”

The paper emphasizes the urgent need for policies and interventions to bridge these gaps. Addressing socioeconomic drivers of healthcare inequities could significantly reduce disparities in imaging use and, by extension, cancer outcomes.

The authors also advocated for a more standardized, evidence-based approach to prostate cancer diagnostics. “Policies could focus on developing MRI-based protocols, particularly multiparametric MRI (mpMRI), as a strategy for reducing diagnostic disparities,” they wrote. “Numerous studies have shown that mpMRI, when used to direct biopsy and aid in risk assessment, improves diagnostic precision and reduces the risk of overdiagnosis and unnecessary biopsies in patients who do not receive adequate comprehensive care.”

As prostate cancer continues to rank among the most rapidly increasing cancers in the U.S.—yet one with relatively low mortality—ensuring equitable access to imaging is critical. Researchers argue that improving diagnostic fairness not only enhances care for underrepresented populations but also reduces the risk of both underdiagnosis and overtreatment across all groups.