Study finds racial/ethnic disparities in use of PSMA-PET in prostate cancer

Non-Hispanic Black and Latinx/Hispanic patients with prostate cancer are less likely to receive PSMA-PET imaging than non-Hispanic White patients, according to data presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois.^1,2

Eunice Hankinson, FNP, MSN

"PSMA-PET imaging is transforming how we detect and manage prostate cancer, but our study shows that not all patients are benefiting equally. Black and Latinx men remain significantly less likely to receive this advanced imaging, highlighting the urgent need to address longstanding inequities in cancer care,” commented lead author Eunice Hankinson, FNP, MSN, an oncology nurse practitioner and clinical director at Flatiron Health in New York, New York, in correspondence with Urology Times®. “High quality real-world data from sources like Flatiron Health play a critical role in revealing how innovations like PSMA-PET are being adopted in clinical practice and in identifying where gaps in access still exist."

In total, the retrospective study included 550 US adult patients who received a diagnosis of metastatic prostate cancer between December 2020 and May 2024. Among all patients, 250 were non-Hispanic White, 250 were non-Hispanic Black, and 50 were Latinx. Data were collected from the US nationwide Flatiron Health electronic health record (EHR)-derived, deidentified database. According to the authors, “receipt of PSMA-PET was determined by manually reviewing unstructured EHR data.”

Multivariable logistic regression was adjusted for age and year of diagnosis. Socioeconomic status (SES) was excluded as a covariate due to it being a mediator.

Non-Hispanic Black and Latinx patients were more likely to have a lower SES compared with non-Hispanic White patients. Non-Hispanic Black patients also tended to be younger than non-Hispanic White and Latinx patients.

More than half of patients (54%) included in the analysis had at least 1 documented PSMA-PET scan. Utilization of PSMA-PET increased over the study period, with a rate of 33.3% in 2021, which increased to 64.9% in 2023.

The authors reported, “The majority (88.9%) of initial scans were completed after the [metastatic] diagnosis date.”

Scans were generally conducted in the hormone-sensitive setting. Specifically, 75% of scans were done in patients with hormone-sensitive disease, compared with 24.7% of scans completed in patients with castration-resistant disease.

Data showed differences in utilization across the racial/ethnic groups assessed, even after accounting for age and year of diagnosis. Overall, 61.2% of non-Hispanic White patients underwent a PSMA-PET scan compared with 50% of non-Hispanic Black patients (adjusted OR, 0.56; 95% CI, 0.38 to 0.82) and 38% of Latinx patients (adjusted OR, 0.37; 95% CI, 0.19 to 0.71).

Based on these findings, the authors concluded, “Our results are consistent with prior research documenting racial/ethnic inequities in the adoption of medical innovations and highlight the need for interventions to promote equitable uptake of diagnostic tools in oncology. Future research should explore potential drivers of racial/ethnic differences in PSMA-PET uptake and their potential impact on [patient] outcomes.”

REFERENCES

1. Hankinson E, Reiss S, Ward PJ, et al. Assessment of racial/ethnic inequities in uptake of PSMA-PET imaging among patients with metastatic prostate cancer in the United States. J Clin Oncol. 2025;43 (suppl 16). doi:10.1200/JCO.2025.43.16_suppl.e13739

2. Assessment of racial/ethnic inequities in uptake of PSMA-PET scans among patients with metastatic prostate cancer in the United States. News release. Flatiron Health. May 2025. Accessed June 6, 2025. https://resources.flatiron.com/publications/assessment-of-racialethnic-inequities-in-uptake-of-psma-pet-scans-among-patients-with-metastatic-prostate-cancer-in-the-united-states