Short- and long-term risk of colorectal adenoma recurrence among whites and blacks
Department of Family Medicine and Community Health; Meyers Primary Care Institute
Colorectal Neoplasms; Adenoma; Epidemiologic Factors; Risk Factors; Continental Population Groups
Clinical Epidemiology | Digestive System Diseases | Health Services Research | Neoplasms | Oncology | Primary Care
BACKGROUND: It is unclear whether the higher burden from colorectal cancer among blacks is due to an increased biological susceptibility.
OBJECTIVE: To determine whether non-Hispanic blacks (blacks) have a higher risk of adenoma recurrence than non-Hispanic whites (whites) after removal of colorectal adenoma.
DESIGN: Secondary analysis of the Polyp Prevention Trial (PPT) data.
SETTING: United States.
PATIENTS: Patients were 1668 self-identified whites and 153 blacks who completed the 4-year trial. Of these, 688 whites and 55 blacks enrolled in a posttrial, passive Polyp Prevention Trial Continued Follow-up Study (PPT-CFS) and underwent another colonoscopy.
MAIN OUTCOME MEASUREMENTS: Recurrence and location of the adenoma and advanced adenoma by race-ethnicity during PPT and cumulative recurrence over a mean follow-up of 8.3 years (range, 4.9-12.4 years) among PPT-CFS enrollees.
RESULTS: Blacks had similar risk of recurrence of adenoma (39.2% vs 39.4%; incidence risk ratio [RR] = .98; 95% CI, .80-1.20) and advanced adenoma (8.5% vs 6.4%; RR = 1.18; 95% CI, .68-2.05) as whites at the end of PPT. Recurrence risk did not differ by colon subsite. Among PPT-CFS enrollees, the cumulative recurrence rate over a maximal follow-up period of 12 years was similar for blacks and whites for adenoma (67.3% vs 67.0%; RR = 1.01; 95% CI, .84-1.21) and advanced adenoma (14.5% vs 16.9%; RR = 1.03; 95% CI, .60-1.79). LIMITATION: There were few blacks in the long-term follow-up study.
CONCLUSIONS: Adenoma and advanced adenoma recurrence did not differ by race. Our study does not support more frequent surveillance colonoscopies for blacks with a personal history of adenoma as an intervention to reduce colorectal cancer disparity. Mosby, Inc. All rights reserved.
DOI of Published Version
Gastrointest Endosc. 2013 Mar;77(3):447-54. doi: 10.1016/j.gie.2012.11.027. Link to article on publisher's site
Laiyemo AO, Doubeni CA, Brim H, Ashktorab H, Schoen RE, Gupta S, Charabaty A, Lanza E, Smoot DT, Platz E, Cross AJ. (2013). Short- and long-term risk of colorectal adenoma recurrence among whites and blacks. Meyers Primary Care Institute Publications. https://doi.org/10.1016/j.gie.2012.11.027. Retrieved from https://escholarship.umassmed.edu/meyers_pp/666