Risk of colorectal adenomas and advanced neoplasia in Hispanic, black and white patients undergoing screening colonoscopy.

Racial and ethnic differences in the risk of premalignant colorectal neoplasia have not been extensively studied. To measure adenoma prevalence among asymptomatic white, black and Hispanic patients undergoing screening colonoscopy. In this cross sectional cohort study, data from individuals ≥50 years undergoing first-time colonoscopy since 2006 at a single tertiary-care medical centre were obtained from the electronic medical record. Adenoma prevalence among whites, blacks and Hispanics was calculated; multivariate Poisson and logistic regression were used to identify factors independently associated with adenoma rates and the presence of advanced adenomas. We identified 5075 eligible subjects: 3542 (70%) whites, 942 (18%) Hispanics and 591 (12%) blacks. The mean age was 62.2 years with 58% women. At least one adenoma was detected in 19%, 22% and 26% of whites, Hispanics and blacks respectively (Hispanics vs. whites P = 0.09; blacks vs. whites P = 0.0001). Isolated proximal adenomas were present in 9% of whites, 11% of Hispanics (P = 0.03) and 11% of blacks (P = 0.03). In multivariate analyses, a higher rate of adenomas was present in Hispanics (RR: 1.37, 95% CI: 1.20-1.57) and blacks (RR: 1.76, 95% CI: 1.52-2.04) than whites. Hispanics and blacks also had an increased risk of advanced adenomas compared to whites (OR(Hispanics) : 2.25, 95% CI: 1.62-3.11; OR(blacks) : 1.91, 95% CI: 1.27-2.86). Adenoma prevalence was higher in blacks and Hispanics than in whites. Both groups were at greater risk of having proximal adenomas in the absence of any distal pathology than whites, where these lesions would have only been detected by colonoscopy. Efforts to promote screening are necessary among diverse, under-represented populations.

Lebwohl B ，Capiak K ，Neugut AI ，Kastrinos F ... -  《-》

Comparison of adenoma detection rate in Hispanics and whites undergoing first screening colonoscopy: a retrospective chart review.

Thoma MN ，Jimenez Cantisano BG ，Hernandez AV ，Perez A ，Castro F ... -  《-》

Whites and blacks have similar risk of metachronous advanced colorectal neoplasia.

Kwah J ，Schroy PC 3rd ，Jacobson BC ，Calderwood AH ... -  《-》

Comparison of Adenoma Detection Rates in Afro-Caribbeans and Non-Hispanic Whites Undergoing First Screening Colonoscopy.

Alvarez A ，Tandon K ，To C ，Imam M ，Shah K ，Hakim S ，Amer H ，Estrada J ，Jimenez B ，Castro FJ ... -  《-》

Colorectal neoplasia detection among black and Latino individuals undergoing screening colonoscopy: a prospective cohort study.

Most prospective studies of screening colonoscopy (SC) in average-risk, asymptomatic individuals have included few minority individuals. Little is known about the prevalence and distribution of adenomas found at screening colonoscopy among black and Latino individuals. To determine the prevalence and distribution of histologically confirmed adenomas among black and Latino participants enrolled in a prospective SC study. Cross-sectional analysis of consecutive patients undergoing SC between 2008 and 2011. Urban academic medical center. Average risk, asymptomatic black and Latino patients aged ≥50 years undergoing SC. Adenoma prevalence and distribution by ethnic group. A total of 584 patients (270 black, 314 Latino) completed SC. Overall, 26.4% had adenomas, and 20% had proximal adenomas. Advanced adenomas occurred in 11.5% (12.2% black vs 10.8% Latino; P = .21) and proximal advanced adenomas in 7.5% (5.9% black vs 8.9% Latino; P = .17). These rates were at least as high as those of other studies that enrolled mainly white participants. Lack of comparison group of white patients. The prevalence of adenomas, advanced adenomas, and proximal adenomas was high in both black and Latino participants. The high prevalence of clinically significant proximal lesions has implications for the choice of colon cancer screening test and colonoscopic surveillance intervals.

Lee KK ，Jandorf L ，Thélèmaque L ，Itzkowitz SH ... -  《-》