Presented by: Fernando J. Kim MD, MPH
Denver Health Medical Center

Introduction

Ethnic minorities often face disparities in access to healthcare and are underrepresented in prostate cancer research. The emergence of advanced techniques, such as MRI fusion ultrasound prostate biopsy system, has revolutionized the diagnosis and management of prostate cancer and it may be pivotal to address healthcare disparities and tailor effective strategies for early detection and treatment.

Objective: This study examines the profile of ethnic minorities undergoing MRI fusion Ultrasound Prostate biopsy using the Koelis system in our safety net hospital post COVID era.

Materials

From August 2022 and February 2023 a total of 65 individuals medical charts were reviewed in the study, including 14 Black individuals, 17 Hispanic individuals, 5 other individuals, and 29 Caucasian individuals.

Results

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The average age of the participants was 63.8 ± 7.4 years. The study also investigated the types of health insurance among the participants. Among the Black participants, 3 individuals had indigent insurance, 7 had Medicaid/Medicare, qand 4 had private insurance. Among the Hispanic participants, 4 had indigent insurance, 12 had Medicaid/Medicare, and 1 had private insurance. The other participants all had Medicare insurance. Among the Caucasian participants, 23 had Medicaid/Medicare, and 6 had private insurance.

Prostate size was measured in cubic centimeters (cm3), with an average size of 59.4 cm3 across all participants. Black participants had an average prostate size of 52.3 cm3, Hispanics 68.5 cm3, other  64.6 cm3, and Caucasian 56.8 cm3.

Clinically significant Pirads scores (4 or 5) were observed in the majority of participants. Among the Black participants, 8 had a Pirads score of 4 and 2 had a score of 5. Among the Hispanic participants, 6 had a score of 4 and 6 had a score of 5. The other  participants had 1 with a score of 4 and 3 with a score of 5. The Caucasian participants had 15 with a score of 4 and 12 with a score of 5.

Gleason scores were analyzed, with the majority of G3+3 scores observed in Caucasian participants (13) compared to Black (5), Hispanic (5), and other  (1) participants. Black participants had scores of 3+4 (3) and 4+3 (2), Hispanic participants had scores of 4+3 (2) and 4+5 (1), and Asian participants had Gleason scores no higher than 3+3.

The International Prostate Symptom Score (IPSS) was assessed, with an average score of 8.3. Other participants had a significantly higher average score of 16.7 compared to the other ethnic groups.

Prostate-specific antigen (PSA) levels were measured, with an average level of 8.5 ± 6.3 ng/ml across all participants. Black participants had an average PSA level of 11.2 ± 7.1 ng/ml, Hispanic participants had an average level of 6.7 ± 3.2 ng/ml, other participants had an average level of 5.5 ± 3.1 ng/ml, and Caucasian participants had an average level of 8.9 ± 7.3 ng/ml.

Conclusion

In summary, this study provides insights into the profile of ethnic minorities undergoing MRI fusion Ultrasound Prostate biopsy using the Koelis system. It highlights variations in prostate size, Pirads scores, Gleason scores, IPSS, and PSA levels among different ethnic groups, indicating potential differences in prostate health characteristics and the need for further investigation.

Funding

none

Lead Authors

Sharon White, MD
Denver Health

Co-Authors

Kyle Szymanski, MD
Denver Health

Ian McComb,
Denver Health

Connie Wolf, MD
Denver Health