Adenoma Detection Rate Among Smokers in an Urban Minority Population: A Retrospective Study

Abstract

Introduction: Cigarette smoking is a leading cause of preventable deaths in the United States (US). An estimated 42.1 million US adults smoke cigarettes. Smoking has been associated with cancers in organs that are not directly exposed to inhaled smoke. African Americans have an increased incidence and younger age of presentation of colorectal cancer. Colorectal adenomas are known precursors for colorectal cancer. The aim of this study is to investigate cigarette smoking as an independent risk factor for colonic adenomas in an urban minority population. Methods: We retrospectively reviewed screening colonoscopies in an urban minority population done over the last five years. Our study population was divided into two groups. Group A consisted of current or former smokers and group B consisted of lifetime non-smokers. The adenoma detection rate (ADR) and advanced adenoma detection (aADR) rate were calculated and compared between the two groups. Results: A total of 230 patients who underwent screening colonoscopies were included in the study. 62.6% (144/230) of the study population was African American, 29.1% (67/230) was Hispanic, and 8.2% (19/230) were of other racial/ethnic groups. 81.3% (187/230) were female. 37.4% (86/230) of study subjects were smokers and were included in group A. Of these, 55.8% (48/86) were current smokers. 62.6% (144/230) were lifetime non-smokers and were included in group B. Average age was 57 years (group A) and 59 years (group B). Average body mass index was similar in both groups: 30.7 in group A and 30.9 in group B. The ADR was 23% in group A compared to 15% in Group B. No significant difference in ADR was seen in former (22%) vs current smokers (23%). The aADR was 9% in group A and 5% in group B. Conclusion: The initial results of this ongoing study suggests an increase in the ADR and aADR among cigarette smokers in minority population. No difference in ADR was noted in current smokers and former cigarette smokers. This study highlights the importance of smoking cessation counseling and considering smoking history in decision making for screening CRC.