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Colonoscopy Screening in Black and White Patients—Reply
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In Reply: Dr Shah and colleagues note that representation of black patients in the Clinical Outcomes Research Initiative (CORI) endoscopic database (6.4%) is significantly lower than the prevalence of black persons in the US population (13.4%). In a separate analysis, we compared the demographics of individuals aged 65 years and older in our database with a Medicare data set and found the endoscopic database to be representative.1 Therefore, the CORI database does appear to reflect the population that receives endoscopic procedures.
There is potential for bias as they suggest. However, we believe that the potential bias is in the direction of underestimating risk in black individuals. Among the cohort receiving screening, 20.1% of black persons and 24.6% of white persons had a positive family history of colorectal cancer. Therefore, higher-risk black individuals do not seem to be overrepresented. It is likely that the black individuals who did not receive colonoscopy . . . [Full Text of this Article]
David A. Lieberman, MD
lieberma@ohsu.edu
Glenn M. Eisen, MD, MPH;
Cynthia D. Morris, PhD
Oregon Health and Science University
Portland
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