251 Detection Rates by Anatomic Location in Caucasians, Hispanics, and Asians

Abstract

INTRODUCTION: Ethnic and racial disparities in colorectal cancer (CRC) incidence and mortality rate have been well studied in the literature. However, no study to date has compared surrogates of precancerous polyp prevalence: adenoma detection rate (ADR), polyp detection rate (PDR), sessile serrated adenoma detection rate (SDR) amongst ethnic groups with respect to polyp location. This study serves to compare ethnicities with respect to ADR, PDR, and SDR in 3 ethnic groups as a function of anatomic location. METHODS: This retrospective nonrandomized nonblinded cohort study utilized prospectively collected data at our single tertiary referral center from the UCICQDRes database. A total of 19 attendings and 55 fellows performed 8,894 colonoscopies from June 2012 to October 2018. Three study subgroups (Asian n = 1505, Hispanic n = 951, and Caucasian n = 6438) were compared for age, gender, BMI, total procedure time (TT), bowel prep score (BPS), cecal intubation rate (CIR), ADR, PDR, and SDR stratified by anatomic location. RESULTS: Asians had the highest BPS and age, while Hispanics had the lowest TT. There were differences in PDR and ADR across the ethnicities in all areas of the colon. For instance, in the cecum, Caucasians had the highest PDR (0.18, P = 0.0007), ADR (0.11, P = 0.0142), and SDR (0.027, P = 0.0034). In the left colon, SDR was not significantly different between the ethnicities. With the exception of transverse colon ADR, Hispanics had the lowest PDR and ADR for all anatomic locations. CONCLUSION: Except for ADR in transverse colon and SDR in the descending colon, Hispanics had significantly lower ADR, PDR, and SDR compared to other ethnicities. That Hispanic patients, in general, had lower detection rates in all anatomic locations may be at least partially attributed to the lower BPS and higher BMI and TT in this group. Further analysis is required to ascertain the effect of these variables. In the cecum and ascending colon, differences in ADR, PDR and SDR were significant between all groups. This study suggests that variations in detection rates based on anatomic location may contribute to variations in CRC incidence rates across ethnicities. Additional studies may be of interest to confirm and further explore these differences, as they may have the potential to warrant ethnicity-dependent CRC screening guidelines.