Variation in Clinically Significant Prostate Cancer on Fusion Biopsy of PI-RADS 3-5 Lesions Based on Ethnicity

Our aim is to investigate the prevalence of clinically significant prostate cancer (Gleason score 3+4 or higher) on fusion biopsy for Prostate Imaging Reporting and Data System (PI-RADS) 3-5 lesions based on ethnicity. A retrospective analysis was conducted on patients who underwent fusion biopsy between 2016 and 2022 at two institutions. The prevalence of Gleason score 3+4 or higher within each ethnic group (Caucasian, African American, and Hispanics) was assessed. Possible correlation between PI-RADS lesion score and race was also assessed. Among the 918 patients included in the analysis, 54% were Caucasian, 29% were African American, and 17% were Hispanic. A total of 1,384 lesions were identified (PI-RADS 3-34%, PI-RADS 4-40%, and PI-RADS 5-26%). The prevalence of clinically significant prostate cancer by PI-RADS score and ethnicity was similar: (PI-RADS 3-Caucasian 13%, African American 13%, and Hispanic 9%, p = .45; PI-RADS 4-Caucasian 42%, African American 34%, and Hispanic 38%, p = .29; PI-RADS 5-Caucasian 63%, African American 64%, and Hispanic 51%, p = .38). In conclusion, the prevalence of clinically significant cancer did not significantly differ across PI-RADS 3-5 among different ethnicities on image-guided fusion biopsy.