MRI is standard for diagnosing prostate cancer in most western countries. But most U.S. men don’t get them

August 5, 2026 - 08:33

Pre-biopsy MRI is now the standard of care for diagnosing prostate cancer in most Western nations. Yet new data show that in the United States, only about one in three men received such a scan before their diagnosis in 2022. That gap puts American patients behind their peers in countries like Germany, the UK, and Australia, where MRI before biopsy is routine.

The numbers come from a review of U.S. insurance claims and electronic health records. Among men who were diagnosed with prostate cancer in 2022, roughly 34 percent had an MRI prior to their biopsy. The rate was higher in academic medical centers and among men with private insurance, but it remained far below the near-universal adoption seen elsewhere.

Why the lag? Experts point to several factors. MRI machines are not always available in smaller clinics, and scheduling a scan can delay the biopsy by days or weeks. There is also a reimbursement issue: Medicare and many insurers pay less for pre-biopsy MRI than for other imaging, which may discourage its use. And some urologists still rely on the older approach of systematic biopsy, where needles sample the prostate in a grid pattern without prior imaging.

The consequences matter. MRI helps spot suspicious lesions, allowing for targeted biopsies that are more likely to catch aggressive cancers while avoiding overdiagnosis of low-risk ones. Without it, some men undergo unnecessary biopsies, while others may have significant tumors missed.

The study authors argue that broader adoption would require both financial incentives and better access to imaging. They also note that the trend is moving in the right direction, as the rate has climbed from roughly 20 percent in 2019. Still, they say, the U.S. has a long way to go to catch up with the rest of the developed world.