Rural Patients Less Likely to Receive Advanced PET Imaging for Prostate Cancer, National Study Finds

A new national study reveals significant disparities in the use of advanced imaging for prostate cancer patients based on where they live, particularly between rural and metropolitan areas. Researchers found that patients living in rural counties were significantly less likely to undergo positron emission tomography (PET) scans, a key diagnostic tool for identifying and staging prostate cancer.

Using Medicare claims data from 2019 to 2021, the study evaluated PET scan use among nearly 500,000 men newly diagnosed with prostate cancer. While 8.4% of patients in metropolitan areas received PET imaging, only 7.3% in urban and 7.2% in rural areas underwent the same scans. The difference was statistically significant, suggesting that geographic location plays a critical role in access to advanced cancer diagnostics.

The study, which examined PET scan rates across hospital referral regions nationwide, found usage varied widely, from as low as 2.2% to as high as 20.8%. Researchers also noted disparities by race: White patients were more likely to receive PET scans than Black or Hispanic patients. Notably, rural Black patients were the least likely to receive PET imaging, with an odds ratio (OR) of 0.69 compared to their metropolitan peers.

“While we’ve long recognized racial disparities in prostate cancer care, this analysis shows that rurality compounds those inequities,” said the authors. “The combined effect of race and geographic location is particularly concerning.”

The underuse of PET imaging in rural areas may stem from limited access to the necessary equipment and radiotracers. PET imaging is a resource-intensive diagnostic tool, requiring specialized scanners and radioactive tracers—resources that may be less available in lower-volume rural hospitals.

Prostate cancer remains one of the most commonly diagnosed cancers among men, and early, accurate staging is critical to effective treatment. PET scans have become increasingly important due to their superior ability to detect metastases compared to traditional imaging methods. They are also being used to guide cutting-edge treatments, such as radioligand therapy.

The study’s authors emphasized the need for strategies to ensure equitable access to PET imaging, particularly as these scans are playing an increasingly important role in cancer diagnosis and treatment.

“Our findings highlight a gap in care that needs urgent attention,” the researchers concluded. “Efforts to expand access to advanced imaging technologies in rural and underserved communities are critical for achieving equity in prostate cancer outcomes.”