Race, ethnicity, and sex affect risk for polyps >9 mm in average-risk individuals.
OBJECTIVE
Colorectal cancer risk differs based on patient demographics. We aimed to measure the prevalence of significant colorectal polyps in average-risk individuals and to determine differences based on age, sex, race, or ethnicity.


METHODS
In a prospective study, colonoscopy data were collected, using an endoscopic report generator, from 327,785 average-risk adults who underwent colorectal cancer screening at 84 gastrointestinal practice sites from 2000 to 2011. Demographic characteristics included age, sex, race, and ethnicity. The primary outcome was the presence of suspected malignancy or large polyp(s) >9 mm. The benchmark risk for age to initiate screening was based on white men, 50-54 years old.


RESULTS
Risk of large polyps and tumors increased progressively in men and women with age. Women had lower risks than men in every age group, regardless of race. Blacks had higher risk than whites from ages 50 through 65 years and Hispanics had lower risk than whites from ages 50 through 80 years. The prevalence of large polyps was 6.2% in white men 50-54 years old. The risk was similar among the groups of white women 65-69 years old, black women 55-59 years old, black men 50-54 years old, Hispanic women 70-74 years old, and Hispanic men 55-59 years old. The risk of proximal large polyps increased with age, female sex, and black race.


CONCLUSIONS
There are differences in the prevalence and location of large polyps and tumors in average-risk individuals based on age, sex, race, and ethnicity. These findings could be used to select ages at which specific groups should begin colorectal cancer screening.
Division of Gastroenterology, Department of Medicine, Oregon Health & Science University, Portland, Oregon. Electronic address: lieberma@ohsu.edu.
David A
DA
Lieberman
Division of Gastroenterology, Department of Medicine, Oregon Health & Science University, Portland, Oregon.
J Lucas
JL
Williams
Division of Gastroenterology, Department of Medicine, Oregon Health & Science University, Portland, Oregon.
Jennifer L
JL
Holub
Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon.
Cynthia D
CD
Morris
Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon.
Judith R
JR
Logan
Division of Gastroenterology, Department of Medicine, Oregon Health & Science University, Portland, Oregon.
Glenn M
GM
Eisen
Department of Family Medicine, Public Health and Preventive Medicine, Oregon Health & Science University, Portland, Oregon.
Patricia
P
Carney
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000473:pathology*; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000208:ethnology* / Q000473:pathology; D003111:Colonic Polyps / Q000175:diagnosis* / Q000208:ethnology* / Q000473:pathology; D003113:Colonoscopy; D018450:Disease Progression; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D044469:Racial Groups; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D047368:Tumor Burden; D014481:United States / Q000453:epidemiology
CRC; Colon Cancer; Early Detection; Rate