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Colorectal neoplasia prevalence higher among African Americans than Hispanics
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SAN DIEGO — Colorectal neoplasia prevalence was higher among young African Americans vs. Hispanics, which could explain the differences in the burden of colorectal cancer among African Americans compared with Hispanics, according to data presented here at the 2012 Digestive Disease Week Annual Meeting.
The disproportionately elevated incidence and mortality from colorectal cancer among African Americans has led to the proposal that African Americans should undergo colorectal cancer screening beginning at 45 years of age.
“Colorectal cancer affects different ethnic groups differently, and based on our own data, African Americans are at more risk than other groups in the US, as they are diagnosed with the disease earlier in life and [tend to] die younger. In addition, their disease is in advanced stage at the time of diagnosis,” Hassan Ashktorab, PhD, associate professor in the department of medicine at the Howard University Cancer Center in Washington, D.C., told HemOnc Today.
To evaluate the prevalence of colorectal neoplasia among 40- to 49-year-old inner-city African Americans and Hispanics, researchers reviewed the colonoscopy reports from 2000 to 2010 at Howard University Hospital in Washington, D.C., and identified 2,435 40- to 49-year-old patients.
There were 2,163 African Americans (mean age, 46 years; 57% females) and 272 Hispanics (mean age, 45 years; 56.6% females). Researchers defined an advanced adenoma as an adenoma of at least 1 cm in diameter or villous histology or high-grade dysplasia or invasive cancer. Familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer were excluded, and data were analyzed using chi-square t test. They also compared the prevalence of neoplasia among 40- to 44-year-olds.
In the 40- to 49-year-old age group, African Americans exhibited a higher prevalence of adenoma compared with Hispanics (15.6%; n=338 vs. 9.6%; n=26; P=.008) and advanced adenomas (4.9% vs. 1.1%; P=.004). Most of the adenomas were located in the distal colon in African Americans vs. Hispanics (49.1% vs. 38.5%, P=.03). Colorectal cancers were diagnosed in 1.1% of African Americans and 0.36% of Hispanics (P=.25). Among African Americans, there was a higher prevalence of adenoma among the 45- to 49-year-old age group vs. the 40- to 44-year-old group (16% vs. 11.8%; P=.01), but not among Hispanics.
“The [American Society for Gastrointestinal Endoscopy] and the American College of Gastroenterology both recommend colorectal cancer screening beginning at age 45 for African Americans,” Ashktorab said. “However, our own data from Howard University indicate that we even have to start screening for colorectal cancer at age 40. It is more useful to increase colorectal cancer screening in all ethnic groups, especially African Americans since they exhibit higher risk than other groups.”
For more information:
- Ashktorab H. #1781. Presented at: the 2012 Digestive Disease Week Annual Meeting; May 19-22, 2012; San Diego.
Disclosure: One of the study researchers reported a speaking and teaching position with Myriad Genetic Laboratories.