Kristin Wallace1,2, Heather M Brandt3,4, James D Bearden5, Bridgette F Blankenship6, Renay Caldwell3, James Dunn5, Patricia Hegedus5, Brenda J Hoffman7,8, Courtney H Marsh6, William H Marsh7, Cathy L Melvin7,6, March E Seabrook3, Ronald E Sterba7, Mary Lou Stinson3, Annie Thibault3, Franklin G Berger3, Anthony J Alberg7,6. 1. Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA. Wallack@musc.edu. 2. Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Charleston, SC, 29425, USA. Wallack@musc.edu. 3. Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA. 4. Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. 5. Gibbs Cancer Center and Research Institute, Spartanburg Regional Healthcare System, Spartanburg, SC, USA. 6. Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Charleston, SC, 29425, USA. 7. Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA. 8. Department of Gastroenterology, Center for Digestive Disease, MUSC, Charleston, SC, USA.
Abstract
BACKGROUND: Compared to whites, blacks have higher colorectal cancer incidence and mortality rates and are at greater risk for early-onset disease. The reasons for this racial disparity are poorly understood, but one contributing factor could be differences in access to high-quality screening and medical care. AIMS: The present study was carried out to assess whether a racial difference in prevalence of large bowel polyps persists within a poor and uninsured population (n = 233, 124 blacks, 91 whites, 18 other) undergoing screening colonoscopy. METHODS: Eligible patients were uninsured, asymptomatic, had no personal history of colorectal neoplasia, and were between the ages 45-64 years (blacks) or 50-64 years (whites, other). We examined the prevalence of any adenoma (conventional, serrated) and then difference in adenoma/polyp type by race and age categories. RESULTS: Prevalence for ≥1 adenoma was 37 % (95 % CI 31-43 %) for all races combined and 36 % in blacks <50 years, 38 % in blacks ≥50 years, and 35 % in whites. When stratified by race, blacks had a higher prevalence of large conventional proximal neoplasia (8 %) compared to whites (2 %) (p value = 0.06) but a lower prevalence of any serrated-like (blacks 18 %, whites 32 %; p value = 0.02) and sessile serrated adenomas/polyps (blacks 2 %, whites 8 % Chi-square p value; p = 0.05). CONCLUSIONS: Within this uninsured population, the overall prevalence of adenomas was high and nearly equal by race, but the racial differences observed between serrated and conventional polyp types emphasize the importance of taking polyp type into account in future research on this topic.
BACKGROUND: Compared to whites, blacks have higher colorectal cancer incidence and mortality rates and are at greater risk for early-onset disease. The reasons for this racial disparity are poorly understood, but one contributing factor could be differences in access to high-quality screening and medical care. AIMS: The present study was carried out to assess whether a racial difference in prevalence of large bowel polyps persists within a poor and uninsured population (n = 233, 124 blacks, 91 whites, 18 other) undergoing screening colonoscopy. METHODS: Eligible patients were uninsured, asymptomatic, had no personal history of colorectal neoplasia, and were between the ages 45-64 years (blacks) or 50-64 years (whites, other). We examined the prevalence of any adenoma (conventional, serrated) and then difference in adenoma/polyp type by race and age categories. RESULTS: Prevalence for ≥1 adenoma was 37 % (95 % CI 31-43 %) for all races combined and 36 % in blacks <50 years, 38 % in blacks ≥50 years, and 35 % in whites. When stratified by race, blacks had a higher prevalence of large conventional proximal neoplasia (8 %) compared to whites (2 %) (p value = 0.06) but a lower prevalence of any serrated-like (blacks 18 %, whites 32 %; p value = 0.02) and sessile serrated adenomas/polyps (blacks 2 %, whites 8 % Chi-square p value; p = 0.05). CONCLUSIONS: Within this uninsured population, the overall prevalence of adenomas was high and nearly equal by race, but the racial differences observed between serrated and conventional polyp types emphasize the importance of taking polyp type into account in future research on this topic.
Entities:
Keywords:
Colorectal adenomas; Race; Screening; Serrated polyps; Socioeconomic status
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