 |
|
Prevalence of Colon Polyps Detected by Colonoscopy Screening in Asymptomatic Black and White Patients
David A. Lieberman, MD;
Jennifer L. Holub, MPH;
Matthew D. Moravec, BS;
Glenn M. Eisen, MD, MPH;
Dawn Peters, PhD;
Cynthia D. Morris, PhD
JAMA. 2008;300(12):1417-1422.
Context Compared with white individuals, black men and women have a higher incidence and mortality from colorectal cancer and may develop cancer at a younger age. Colorectal cancer screening might be less effective in black individuals, if there are racial differences in the age-adjusted prevalence and location of cancer precursor lesions.
Objectives To determine and compare the prevalence rates and location of polyps sized more than 9 mm in diameter in asymptomatic black and white individuals who received colonoscopy screening.
Design, Setting, and Patients Colonoscopy data were prospectively collected from 67 adult gastrointestinal practice sites in the United States using a computerized endoscopic report generator between January 1, 2004, and December 31, 2005. Data were transmitted to a central data repository, where all asymptomatic white (n = 80 061) and black (n = 5464) patients who had received screening colonoscopy were identified.
Main Outcome Measures Prevalence and location of polyps sized more than 9 mm, adjusted for age, sex, and family history of colorectal cancer in a multivariate analysis.
Results Both black men and women had a higher prevalence of polyps sized more than 9 mm in diameter compared with white men and women (422[7.7%] vs 4964 [6.2%]; P < .001). Compared with white patients, the adjusted odds ratio (OR) for black men was 1.16 (95% confidence interval [CI], 1.01-1.34) and the adjusted OR for black women was 1.62 (95% CI, 1.39-1.89). Black and white patients had a similar risk of proximal polyps sized more than 9 mm (OR, 1.13;95% CI, 0.93-1.38). However, in a subanalysis of patients older than 60 years, proximal polyps sized more than 9 mm were more likely prevalent in black men (P = .03) and women (P < .001) compared with white men and women.
Conclusion Compared with white individuals, black men and women undergoing screening colonoscopy have a higher risk of polyps sized more than 9 mm, and black individuals older than 60 years are more likely to have proximal polyps sized more than 9 mm.
Author Affiliations: Division of Gastroenterology, Portland VA Medical Center, Portland, Oregon (Dr Lieberman); and Division of Gastroenterology and Hepatology (Drs Lieberman and Eisen, and Ms Holub and Mr Moravec), Division of Biostatistics, Department of Public Health and Preventive Medicine (Dr Peters), and Department of Medical Informatics and Clinical Epidemiology (Dr Morris), Oregon Health and Science University, Portland.
RELATED ARTICLES
Colorectal Cancer Risk: Black, White, or Shades of Gray?
Hemant K. Roy and Laura K. Bianchi
JAMA. 2008;300(12):1459-1461.
EXTRACT
| FULL TEXT
Colon Polyps
Janet M. Torpy, Cassio Lynm, and Richard M. Glass
JAMA. 2008;300(12):1480.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Screening for Colorectal Cancer in Black Americans
JWatch Gastroenterology 2008;2008:2-2.
FULL TEXT
Race, Sex, and Age Differences in the Prevalence of Colon Polyps
JWatch General 2008;2008:1-1.
FULL TEXT
Colorectal Cancer Risk: Black, White, or Shades of Gray?
Roy and Bianchi
JAMA 2008;300:1459-1461.
FULL TEXT
|
