Prevalence of colon polyps detected by colonoscopy screening in asymptomatic black and white patients

Context Compared with white individuals, black men and women have a higher incidence and mortality from colorectal cancer and may develop cancer at a younger age. Colorectal cancer screening might be less effective in black individuals, if there are racial differences in the age- adjusted prevalence and location of cancer precursor lesions. Objectives To determine and compare the prevalence rates and location of polyps sized more than 9 mm in diameter in asymptomatic black and white individuals who received colonoscopy screening. Design, Setting, and Patients Colonoscopy data were prospectively collected from 67 adult gastrointestinal practice sites in the United States using a computerized endoscopic report generator between January 1, 2004, and December 31, 2005. Data were transmitted to a central data repository, where all asymptomatic white ( n = 80 061) and black ( n= 5464) patients who had received screening colonoscopy were identified. Main Outcome Measures Prevalence and location of polyps sized more than 9 mm, adjusted for age, sex, and family history of colorectal cancer in a multivariate analysis. Results Both black men and women had a higher prevalence of polyps sized more than 9 mm in diameter compared with white men and women ( 422 [ 7.7%] vs 4964 [ 6.2%]; P <. 001). Compared with white patients, the adjusted odds ratio ( OR) for black men was 1.16 ( 95% confidence interval [ CI], 1.01- 1.34) and the adjusted OR for black women was 1.62 ( 95% CI, 1.39- 1.89). Black and white patients had a similar risk of proximal polyps sized more than 9 mm( OR, 1.13; 95% CI, 0.93- 1.38). However, in a subanalysis of patients older than 60 years, proximal polyps sized more than 9 mm were more likely prevalent in black men ( P=. 03) and women ( P <. 001) compared with white men and women. Conclusion Compared with white individuals, black men and women undergoing screening colonoscopy have a higher risk of polyps sized more than 9 mm, and black individuals older than 60 years are more likely to have proximal polyps sized more than 9 mm.