Variation and Disparity in the Use of Prostate Cancer Risk Stratification Tools in the United States

Eur Urol Focus. 2022 Jul;8(4):910-912. doi: 10.1016/j.euf.2022.06.003. Epub 2022 Jun 28.


In this review we summarize evidence from US studies examining variation in the use of prostate magnetic resonance imaging (MRI) and tissue-based gene expression tests (genomic tests), focusing on sources of regional and racial variation. Large observational studies indicate that prostate MRI and genomic testing vary significantly at the regional level as measured across multiple geographic boundaries. Similarly, there is lower use of prostate MRI among Black versus White-identified patients Black in comparison to those who are White, as well as evidence of less use among Hispanic and Asian versus White patients. These findings indicate opportunities to address modifiable sources of practice variation in localized prostate cancer. PATIENT SUMMARY: In this review, we found that use of prostate magnetic resonance imaging (MRI) scans and genetic testing differed by region, and race, with less prostate MRI use among Black versus White patients. These findings can help raise awareness about gaps in access to new prostate cancer tools.

Keywords: Disparity; Genomic testing; Prostate cancer; Prostate magnetic resonance imaging.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Black or African American
  • Hispanic or Latino
  • Humans
  • Male
  • Prostatic Neoplasms* / diagnostic imaging
  • Prostatic Neoplasms* / pathology
  • Risk Assessment
  • United States / epidemiology
  • White People*