Original article
Clinical endoscopy
Comparison of adenoma detection rate in Hispanics and whites undergoing first screening colonoscopy: a retrospective chart review

https://doi.org/10.1016/j.gie.2012.11.003Get rights and content

Background

Current guidelines recommend screening colonoscopy beginning at age 50 in the average-risk population. Race has been shown to influence the risk of colorectal cancer, thus leading to the recommendation of initiating screening in blacks at the age of 45. Few data exist on the prevalence of colon polyps among U.S. Hispanics.

Objectives

To compare the adenoma detection rate (ADR) between Hispanics and whites undergoing a first screening colonoscopy at our referral center.

Design

Observational study.

Setting

Single endoscopy unit, tertiary care teaching hospital.

Patients

Patients 50 years of age or older undergoing their first screening colonoscopy whose race was determined as white or Hispanic from June 2007 to August 2010.

Main Outcome Measurement

ADR by race.

Results

There was no statistically significant difference in the ADR among Hispanics and whites (45% and 48%, respectively; P = .2). No difference was found when comparing the ADR in Hispanic and white males (50% and 55%, respectively; P = .2), Hispanic and white females (40% in both groups), or in the 50- to 59-year-old subgroup (42% in Hispanics, 45% in whites, P = .4). There was no difference in the prevalence of advanced adenomas (3% in Hispanics, 4% in whites, P = .3). The prevalence of proximal polyps in Hispanics and whites was similar (18% and 19%, respectively, P = .8).

Limitations

Retrospective design, self-identification of race/ethnicity, underrepresentation of certain Hispanic subgroups.

Conclusions

We found a similar ADR among Hispanics and whites undergoing their first screening colonoscopy. These findings have important implications for colorectal cancer screening recommendations, suggesting that the current guidelines are appropriate for Hispanics.

Section snippets

Background and introduction

Current guidelines recommend screening colonoscopy beginning at age 50 for the detection of colorectal neoplasia in the average-risk population.1 Other factors beyond age including race may influence the risk of colorectal cancer (CRC). Thus, it seems paramount to understand which populations are at increased risk to target and improve screening strategies.

By 2010, there were an estimated 50.5 million Americans identified as Hispanic, comprising 16% of the total U.S. population according to the

Patients

In this observational study, the results of 10,607 colonoscopies performed in a single endoscopy unit at a tertiary care teaching hospital in Florida were analyzed. Consecutive patients whose race/ethnicity was determined as white or Hispanic with an age older than 50 undergoing their first screening colonoscopy from May 2007 to August 2010 were included. The classification of race/ethnicity in the medical chart is noted by office personnel based on information provided by the patient. This

Baseline characteristics

Between May 2007 and August 2010, a total of 10,607 colonoscopies were performed at our institution. After we applied exclusion criteria, a total of 1858 screening colonoscopies by 9 attending gastroenterologists were included in our study. The baseline characteristics of the patients included in the study are shown in Table 1. Thirty-two percent of the patients were Hispanic. There was no difference in the age between the 2 groups, with a mean age in the Hispanic patients of 56.5 years and

Discussion

We compared the ADR in Hispanic and white individuals undergoing their first screening colonoscopy. We found a similar ADR in Hispanics and whites. Subgroup analysis of Hispanic versus white males and Hispanic versus white females also revealed comparable ADR.

The higher incidence of CRC and adenomas in blacks9 has led to the recommendation to begin CRC screening in this group at age 45.1 The incidence of CRC is reported to be lower in Hispanics than it is among whites.10, 11 A possibility of

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    DISCLOSURE: The authors disclosed no financial relationships relevant to this publication.

    If you would like to chat with an author of this article, you may contact Dr Jimenez Cantisano at [email protected].

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