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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Lieberman and colleagues¹ concluded that black individuals are at higher risk of having polyps larger than 9 mm compared with white individuals. However, this conclusion may be incomplete for several reasons.

Black individuals represented only 6.4% of the population studied. In contrast, black persons represent 13.4% of the US population.² This raises the possibility of bias in the population examined, particularly if black individuals who underwent screening were at elevated risk for colorectal cancer or polyps compared with the general black population. Additionally, although the data were obtained from a national endoscopic database, the underrepresentation of black persons raises concern that they may not be receiving colon cancer screening in adequate numbers compared with white individuals. This leads to the question of what is different about the small number of black individuals who chose to have a colonoscopy vs those who did not. These issues are . . . [Full Text of this Article]

Jessica Shah, MD
jessica.shah@utsouthwestern.edu

Samir Gupta, MD; Don C. Rockey, MD
Division of Digestive and Liver Diseases
University of Texas Southwestern Medical Center
Dallas

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