Portal de Periódicos da CAPES

Risk of colorectal adenomas and advanced neoplasia in H ispanic, black and white patients undergoing screening colonoscopy

2012; Wiley; Volume: 35; Issue: 12 Linguagem: Inglês

10.1111/j.1365-2036.2012.05119.x

1365-2036

Benjamin Lebwohl, Kristina M. Capiak, Alfred I. Neugut, Fay Kastrinos,

Genetic factors in colorectal cancer

Summary Background Racial and ethnic differences in the risk of premalignant colorectal neoplasia have not been extensively studied. Aim To measure adenoma prevalence among asymptomatic white, black and H ispanic patients undergoing screening colonoscopy. Methods 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 H ispanics was calculated; multivariate P oisson and logistic regression were used to identify factors independently associated with adenoma rates and the presence of advanced adenomas. Results We identified 5075 eligible subjects: 3542 (70%) whites, 942 (18%) H ispanics 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, H ispanics and blacks respectively ( H ispanics vs. whites P = 0.09; blacks vs. whites P = 0.0001). Isolated proximal adenomas were present in 9% of whites, 11% of H ispanics ( P = 0.03) and 11% of blacks ( P = 0.03). In multivariate analyses, a higher rate of adenomas was present in H ispanics ( 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 H ispanics : 2.25, 95% CI : 1.62–3.11; OR blacks : 1.91, 95% CI : 1.27–2.86). Conclusions Adenoma prevalence was higher in blacks and H ispanics 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.