title: Location-dependent ethnic differences in the risk of colorectal adenoma: a retrospective multiethnic study.
abstract: OBJECTIVE
  Epidemiological data have demonstrated that Hispanics have a lower incidence rate of colorectal cancer (CRC) compared with other major race/ethnicity groups in the United States. However, data regarding the relative prevalence of colorectal adenomas (CRAs) in Hispanic versus non-Hispanic populations are currently sparse and inconclusive.
  
  
  METHODS
  We conducted a retrospective review of colonoscopy patients (n=1656) at a single tertiary-care community hospital from 2007 to 2011, to evaluate the association of self-reported race/ethnicity status with CRA prevalence and characteristics. Established CRC risk factors were also included in multivariate regression models.
  
  
  RESULTS
  Overall, the CRA prevalence was lower in Hispanic subjects than non-Hispanic subjects (14.8% vs. 22.5%) and this difference was statistically significant (adjusted odds ratio, 0.67; 95% confidence interval, 0.47-0.96; P<0.01). Conversely, no difference in CRA prevalence was observed between non-Hispanic white and black subjects. Further analyses by adenoma location revealed more pronounced reduction in proximal CRA prevalence for Hispanics versus non-Hispanics (5.3% vs. 13.1%; adjusted odds ratio, 0.42; 95% confidence interval, 0.26-0.70; P<0.001), whereas CRA prevalence in distal colon, rectum or multiple locations did not differ significantly between race/ethnicity groups.
  
  
  CONCLUSIONS
  Our data showed a marked distinction in CRA prevalence, particularly proximal adenomas, between Hispanics and non-Hispanics. Additional multicenter studies are needed to confirm these findings, elucidate the underlying mechanisms, and clarify the implications for CRC screening and other preventive and/or therapeutic interventions.
authors: *Department of Medicine †Division of Gastroenterology and Hepatology ‡Division of Hematology and Oncology, Nassau University Medical Center, East Meadow ¶New York College of Osteopathic Medicine, Old Westbury, NY §Carolina Population Center & Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors: Xi E
authors: XE
authors: Zheng
authors: Ting
authors: T
authors: Li
authors: Seth
authors: S
authors: Lipka
authors: Evan
authors: E
authors: Levine
authors: Raymond
authors: R
authors: Vlacancich
authors: Umeko
authors: U
authors: Takeshige
authors: Paul
authors: P
authors: Mustacchia
authors: Alan
authors: A
authors: Multz
authors: Vladimir
authors: V
authors: Gotlieb
mesh_terms: D000236:Adenoma / Q000453:epidemiology* / Q000208:ethnology / Q000473:pathology; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000473:pathology; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D014481:United States; D044465:White People / Q000706:statistics & numerical data