TY - JOUR
T1 - Occurrence of Distal Colorectal Neoplasia Among Whites and Blacks Following Negative Flexible Sigmoidoscopy
T2 - An Analysis of PLCO Trial
AU - Laiyemo, Adeyinka O.
AU - Doubeni, Chyke
AU - Pinsky, Paul F.
AU - Doria-Rose, V. Paul
AU - Bresalier, Robert
AU - Hickey, Thomas
AU - Riley, Thomas
AU - Church, Tim R.
AU - Weissfeld, Joel
AU - Schoen, Robert E.
AU - Marcus, Pamela M.
AU - Prorok, Philip C.
N1 - Publisher Copyright:
© 2015, Society of General Internal Medicine.
PY - 2015/10/29
Y1 - 2015/10/29
N2 - BACKGROUND: It is unclear whether the higher rate of colorectal cancer (CRC) among non-Hispanic blacks (blacks) is due to lower rates of CRC screening or greater biologic risk. OBJECTIVE: We aimed to evaluate whether blacks are more likely than non-Hispanic whites (whites) to develop distal colon neoplasia (adenoma and/or cancer) after negative flexible sigmoidoscopy (FSG). DESIGN: We analyzed data of participants with negative FSGs at baseline in the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial who underwent repeat FSGs 3 or 5 years later. Subjects with polyps or masses were referred to their physicians for diagnostic colonoscopy. We collected and reviewed the records of diagnostic evaluations. PARTICIPANTS: Our analytic cohort consisted of 21,550 whites and 975 blacks. MAIN MEASURES: We did a comparison by race (whites vs. blacks) in the findings of polyps or masses at repeat FSG, the follow-up of abnormal test results and the detection of colorectal neoplasia at diagnostic colonoscopy. KEY RESULTS: At the follow-up FSG examination, 304 blacks (31.2 %) and 4183 whites (19.4 %) had abnormal FSG, [adjusted relative risk (RR) = 1.00; 95 % confidence interval (CI), 0.90–1.10]. However, blacks were less likely to undergo diagnostic colonoscopy (76.6 % vs. 83.1 %; RR = 0.90; 95 % CI, 0.84–0.96). Among all included patients, blacks had similar risk of any distal adenoma (RR = 0.86; 95 % CI, 0.65–1.14) and distal advanced adenoma (RR = 1.01; 95 % CI, 0.60–1.68). Similar results were obtained when we restricted our analysis to compliant subjects who underwent diagnostic colonoscopy (RR = 1.01; 95 % CI, 0.80–1.29) for any distal adenoma and (RR = 1.18; 95 % CI, 0.73–1.92) for distal advanced adenoma. CONCLUSIONS: We did not find any differences between blacks and whites in the risk of distal colorectal adenoma 3–5 years after negative FSG. However, follow-up evaluations were lower among blacks.
AB - BACKGROUND: It is unclear whether the higher rate of colorectal cancer (CRC) among non-Hispanic blacks (blacks) is due to lower rates of CRC screening or greater biologic risk. OBJECTIVE: We aimed to evaluate whether blacks are more likely than non-Hispanic whites (whites) to develop distal colon neoplasia (adenoma and/or cancer) after negative flexible sigmoidoscopy (FSG). DESIGN: We analyzed data of participants with negative FSGs at baseline in the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial who underwent repeat FSGs 3 or 5 years later. Subjects with polyps or masses were referred to their physicians for diagnostic colonoscopy. We collected and reviewed the records of diagnostic evaluations. PARTICIPANTS: Our analytic cohort consisted of 21,550 whites and 975 blacks. MAIN MEASURES: We did a comparison by race (whites vs. blacks) in the findings of polyps or masses at repeat FSG, the follow-up of abnormal test results and the detection of colorectal neoplasia at diagnostic colonoscopy. KEY RESULTS: At the follow-up FSG examination, 304 blacks (31.2 %) and 4183 whites (19.4 %) had abnormal FSG, [adjusted relative risk (RR) = 1.00; 95 % confidence interval (CI), 0.90–1.10]. However, blacks were less likely to undergo diagnostic colonoscopy (76.6 % vs. 83.1 %; RR = 0.90; 95 % CI, 0.84–0.96). Among all included patients, blacks had similar risk of any distal adenoma (RR = 0.86; 95 % CI, 0.65–1.14) and distal advanced adenoma (RR = 1.01; 95 % CI, 0.60–1.68). Similar results were obtained when we restricted our analysis to compliant subjects who underwent diagnostic colonoscopy (RR = 1.01; 95 % CI, 0.80–1.29) for any distal adenoma and (RR = 1.18; 95 % CI, 0.73–1.92) for distal advanced adenoma. CONCLUSIONS: We did not find any differences between blacks and whites in the risk of distal colorectal adenoma 3–5 years after negative FSG. However, follow-up evaluations were lower among blacks.
KW - PLCO
KW - adenomatous polyps
KW - colorectal cancer disparities
KW - flexible sigmoidoscopy
KW - screening
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UR - http://www.scopus.com/inward/citedby.url?scp=84942502809&partnerID=8YFLogxK
U2 - 10.1007/s11606-015-3297-3
DO - 10.1007/s11606-015-3297-3
M3 - Article
C2 - 25835747
AN - SCOPUS:84942502809
SN - 0884-8734
VL - 30
SP - 1447
EP - 1453
JO - Journal of general internal medicine
JF - Journal of general internal medicine
IS - 10
ER -
