title: Prevalence of adenomas and sessile serrated adenomas in Chinese compared with Caucasians.
abstract: OBJECTIVE
  Colonic adenomas and sessile serrated adenomas (SSA) are the most common premalignant polyps identified at colonoscopy. This study compares the prevalence of neoplastic polyps in Chinese and Caucasians in a general gastroenterology outpatient practice in Australia.
  
  
  METHODS
  This study included consecutive unselected colonoscopies performed for standard clinical indications by a single endoscopist (JMH). All polyps detected were measured, resected, and sent for histopathology. The prevalence of adenomas, advanced adenomas, SSA, and cancer in the Chinese and Caucasian cohorts were compared. Advanced adenomas were defined as adenomas > 10 mm, villous histology, or high-grade dysplasia.
  
  
  RESULTS
  The study included 346 Chinese and 654 Caucasians. There was no significant difference in the baseline characteristics including age, gender, and indications of colonoscopy, although Chinese were more likely to present with rectal bleeding (22.8% vs 15.9%, P = 0.01). The prevalence of adenomatous polyps was similar in both Caucasians (34.3%) and Chinese (35.3%). However, advanced adenomas were more significantly common in Caucasians (11.3%) compared with Chinese (4.6%) (P < 0.001). SSA was rare in Chinese (2%) but present more frequently in Caucasians (7%) (P = 0.001). Multivariate analysis showed that Caucasian ethnicity (odds ratio 2.4, 95% confidence interval 1.6-3.6) and the presence of SSA (odds ratio 4.4, 95% confidence interval 2.3-8.6) were independent predictors for the detection of an advanced adenoma.
  
  
  CONCLUSIONS
  The prevalence of significant colorectal lesions, including advanced adenomas, large adenomas, and SSA, were lower in Chinese compared with Caucasians. These findings may influence the guidelines for colonic cancer screening in Chinese populations.
authors.affiliation: Department of Gastroenterology, The Sutherland Hospital, Sydney, New South Wales, Australia.
authors.forename: Vivek
authors.initials: V
authors.lastname: Kumbhari
authors.forename: Jason
authors.initials: J
authors.lastname: Behary
authors.forename: Jason Minco
authors.initials: JM
authors.lastname: Hui
mesh_terms: D000236:Adenoma / Q000208:ethnology* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000208:ethnology*; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000208:ethnology* / Q000473:pathology; D003111:Colonic Polyps / Q000208:ethnology* / Q000473:pathology; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D044465:White People / Q000208:ethnology*; D055815:Young Adult