Sex, age, family history associated with increased risk for large proximal colon polyps

Black men and women and those aged older than 60 years may be at an increased risk for colon polyps larger than 9 mm in diameter, compared with white men and women, according to data published today in JAMA.

Researchers at Portland VA Medical Center and Oregon Health and Science University conducted a prospective analysis to determine the prevalence of colon polyps larger than 9 mm in black and white people undergoing colonoscopy screening.

The study included 85,525 asymptomatic participants aged older than 18 years. In a multivariate analysis, the researchers adjusted for age, sex and family history of colorectal cancer.

Of 5,464 black participants, 422 (7.7%) had one or more polyps sized more than 9 mm, compared with 4,964 (6.2%) of 80,061 white participants (P<.001).

Participants aged older than 50 years were also at an increased risk for polyps larger than 9 mm, though the risk was magnified when those aged between 60 and 69 years were compared with those aged between 50 and 59 years (OR=1.72 vs. 1.23).

Compared with women, men had a higher risk for polyps larger than 9 mm, regardless of race. After adjusting, the researchers reported that black women were at an increased risk, compared with white women (OR=1.62; 95% CI, 1.39-1.89). Differences were also reported between black and white men (OR=1.16; 95% CI, 1.01-1.34).

The prevalence of proximal polyps larger than 9 mm in diameter was higher in black men (P=.03) and black women (P<.001), compared with white men and women.

The researchers reported age older than 60 years, female sex and family history of colorectal cancer or polyps to be associated with the risk for proximal vs. distal polyps larger than 9 mm in diameter.

JAMA. 2008;300:1417-1422.