Racial Differences in Colorectal Polyp and Cancer Detection Rates and Their Locations among Individuals Aged Less Than 50y in an Urban Medical Center

Abstract

Purpose: Colorectal cancer (CRC) is the second leading cause of cancer deaths in the US. The consensus is that most of the CRCs arise from adenomatous polyps. The ASGE, AGA, USMSTF, and ACS guidelines recommend colorectal screening for average-risk individuals at age 50, and colonoscopy is the preferred modality. Death rates from colorectal cancer are ˜30% higher in African Americans (AA) than in whites and twice the rates in Hispanics. The purpose of this study was to examine the racial differences in the occurrence of colorectal polyps and cancers in patients under the age 50. Methods: A retrospective chart review was conducted on 329 individuals <50y old, who underwent a colonoscopy in year 2008 for any indication. We reviewed demographics, medical history, medications, colonoscopy and pathology records. Exclusion criteria: inadequate preparation, incomplete exam, IBD and patients with family history of colon cancer. The data was analyzed in three groups (AA, Hispanic, and non-AA) using chi-square analysis. Results: 305 qualified patients; 117 | (38.37), 188 | (61.63%). M ean age of 40.56y + 8 SD; (age range: 10y-49y). No statistically significant differences were noted in adenomas detection rate between | (13.33%) a nd | (10.53%) (P=0.44). The mean age of occurrence of adenomas in different races was 42 years in AAs, 41 years Hispanics, 40.3 years non-AAs. Two cancers were detected in a 35 year old white female patient and a 47 year old AA patient. Conclusion: (1) Right sided only adenomas were noted in all groups and more frequently in AAs (17.1%) Vs. Hispanics (2%) (P=0.0101) vs. non-AAs (11.8%) (P = 0.0557) which was statistically significant. (2) There is no statistical significance in mean age of occurrence of adenomas in different races. (3) The occurrence of adenomas was similar in males and females (P=0.5568). These findings suggest that a modality to screen both right and left sided colonic polyps (i.e., colonoscopy rather than sigmoidoscopy) should be used for all races and specifically for AAs.Table: Results