Introduction Data suggest that there are gender- and race-based differences in the prevalence of colorectal polyps and cancer. However, most of the data are uncontrolled or derived from studies done in populations where African Americans (AAs) are only a small minority of the population. There is a paucity of data about direct race and gender comparisons where AAs and Caucasian Americans (CAs) are in roughly equal numbers.
Methods Adults undergoing first-time colonoscopy performed at our institution from July 1, 2004, to June 30, 2005, formed the database. We excluded patients who were less than 18 years old. We recorded age, race, gender, height, body weight, family history of colon cancer, alcohol or tobacco use, and colonoscopic and pathologic findings. We calculated body mass index (BMI). Statistical analysis was performed using Student's t-test, chi-square test, and logistical regression as appropriate.
Results 1,175 subjects underwent colonoscopy during this period. Of these, 930 met inclusion criteria. Of these, 59.5% were AAs and 40.5% were CAs, with 64.5% females. The mean age was 53.7(± 12.0) years, whereas the mean BMI was 29.9(± 7.7); 29.5% used tobacco, 20.5% used alcohol, and 15.6% had a family history of colon cancer. We found no difference between AAs (19.9%) versus CAs (21.2%) with respect to the incidence of adenomatous polyps. Logistical regression revealed that age > 50 years (23.3% vs 14.1%) and male sex (24.6% vs 18.2%) were independent risk factors (p < .05). Neither race nor gender had effect on number of adenomas. However, AAs did show a trend toward having higher-grade neoplasia. There was no impact of obesity, smoking, or alcohol abuse.
Conclusion Males but not AAs have a higher risk for adenomas; however, AAs do have an increased incidence of higher-grade neoplasia. BMI and tobacco or alcohol use have no impact.
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