title: The association of age and race and the risk of large bowel polyps.
abstract: BACKGROUND
  Blacks have a higher incidence of colorectal cancer and a younger age at diagnosis compared with whites. Few studies have investigated racial differences in risk of metachronous adenomas and serrated polyps and whether this risk differs by polyp characteristics or age of patient.
  
  
  METHODS
  We analyzed data pooled from three placebo-controlled adenoma chemoprevention trials to explore racial differences in the risk of large bowel polyps in patients ≤50 and >50 years of age. Using generalized linear regression, we estimated risk ratios (RR) and 95% confidence intervals (CI) as measures of the association between race and risk of one or more adenomas or serrated polyps after randomization.
  
  
  RESULTS
  Among the 2,605 subjects who completed at least one follow-up exam, blacks ≤50 years of age had a higher risk of any conventional adenoma (RR, 1.70; 95% CI, 0.99-2.92) and advanced neoplasms (RR, 4.05; 95% CI, 1.43-11.46) and a nonsignificantly lower risk of serrated polyps (RR, 0.75; 95% CI, 0.34-1.62) compared with whites. Among patients >50 years, there was no racial difference in risk of adenomas (RR, 1.08; 95% CI, 0.92-1.27) or advanced neoplasms (RR, 1.05; 95% CI, 0.71- 1.56). However, blacks had a significantly lower risk of serrated polyps (RR, 0.65; 95% CI, 0.49-0.87) than whites.
  
  
  CONCLUSIONS
  Our results demonstrate a higher risk of metachronous adenomas in blacks compared with whites at younger ages.
  
  
  CONCLUSIONS
  Our results suggest that the racial disparity in colorectal cancer incidence may be due to an excess of neoplasia in younger blacks.
authors.affiliation: Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina. Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina. wallack@musc.edu.
authors.forename: Kristin
authors.initials: K
authors.lastname: Wallace
authors.affiliation: Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Burke
authors.affiliation: Department of Medicine, University of Colorado Denver School of Medicine, Denver, Colorado.
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Ahnen
authors.affiliation: Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Barry
authors.affiliation: Departments of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Bresalier
authors.affiliation: Department of Medicine, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Fred
authors.initials: F
authors.lastname: Saibil
authors.affiliation: Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. Department of Medicine, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: John A
authors.initials: JA
authors.lastname: Baron
mesh_terms: D000236:Adenoma / Q000208:ethnology; D000328:Adult; D000367:Age Factors; D000368:Aged; D044383:Black People / Q000208:ethnology*; D003111:Colonic Polyps / Q000208:ethnology*; D015179:Colorectal Neoplasms / Q000208:ethnology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires; D044465:White People / Q000208:ethnology*