A Systematic Review for Health Disparities and Inequities in Multiparametric Magnetic Resonance Imaging for Prostate Cancer Diagnosis

The terms Disparities and Inequities are used almost interchangeably in Health Services Research. Specifically, well-established health disparities exist both in diagnostic imaging utilization and in prostate cancer (PCa) outcomes. In fact, African Americans (AAs) suffer PCa with almost twice the incidence and mortality compared to Non-Hispanic Whites (NHW). What is often overlooked in the current knowledge of PCa disparities is the transition from health disparities into health inequities outcomes. In fact, disparities refer to a certain difference (lack of parity), while inequities refer to unfairness, which is both avoidable and preventable.

Multiparametric Magnetic Resonance (mpMRI) is a novel procedure recommended recently in PCa diagnosis due to its superior ability to detect cancerous lesions. Ideally, having such innovative technology could potentially save lives and thus, should be accessible to all who need it. The main drive of our work is to examine the underlying disparity factors relating to mpMRI adoption in PCa diagnosis. The main goal behind our systematic review was to demonstrate whether a valuable but expensive diagnostic test in PCa is being used efficiently and whether its utilization profile is contributing to widening the inequity gap in PCa outcomes.

Our review is unique as it depicts a model for health disparities research illustrating its transition to inequities and unraveling a potential unfairness in PCa outcomes. We hope our review increases the awareness on an additional disparity factor in PCa. We further hope mpMRI would become more accessible, especially to minority groups who are suffering from this disease with high incidence. This would be of utmost importance especially since recent evidence suggests disparities in PCa outcomes no longer exist when equitable access to care is achieved.

Written by: Christiane J. El Khoury¹ Pablo R. Ros^1,2

Department of Radiology, Stony Brook University, Stony Brook, NY
Department of Pathology, Stony Brook University, Stony Brook, NY

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