Colorectal neoplasia detection among black and Latino individuals undergoing screening colonoscopy: A prospective cohort study

摘要

Background Most prospective studies of screening colonoscopy (SC) in average-risk, asymptomatic individuals have included few minority individuals. Little is known about the prevalence and distribution of adenomas found at screening colonoscopy among black and Latino individuals. Objective To determine the prevalence and distribution of histologically confirmed adenomas among black and Latino participants enrolled in a prospective SC study. Design Cross-sectional analysis of consecutive patients undergoing SC between 2008 and 2011. Setting Urban academic medical center. Patients Average risk, asymptomatic black and Latino patients aged ≥50 years undergoing SC. Intervention SC. Main Outcome Measurements Adenoma prevalence and distribution by ethnic group. Results A total of 584 patients (270 black, 314 Latino) completed SC. Overall, 26.4% had adenomas, and 20% had proximal adenomas. Advanced adenomas occurred in 11.5% (12.2% black vs 10.8% Latino; P =.21) and proximal advanced adenomas in 7.5% (5.9% black vs 8.9% Latino; P =.17). These rates were at least as high as those of other studies that enrolled mainly white participants. Limitations Lack of comparison group of white patients. Conclusion The prevalence of adenomas, advanced adenomas, and proximal adenomas was high in both black and Latino participants. The high prevalence of clinically significant proximal lesions has implications for the choice of colon cancer screening test and colonoscopic surveillance intervals.