TY - JOUR
T1 - Ethnic variations in the occurrence of colonic neoplasms
AU - Sonnenberg, Amnon
AU - Turner, Kevin O.
AU - Genta, Robert M.
N1 - Publisher Copyright:
© 2016, © Author(s) 2016.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Background and aims: With the exception of African Americans and Hispanics, few studies have dealt with the influence of other types of ethnicity on the prevalence of colon polyps and colorectal cancer. The present study was undertaken to compare the ethnic and socioeconomic distributions of colonic neoplasms among different ethnic groups in the United States. Methods: A total of 813,057 patients, who underwent colonoscopy during 2008–2014, were recruited from an electronic database of histopathology reports (Miraca Life Sciences) for a cross-sectional study. Using multivariate logistic regression analyses, the presence of hyperplastic polyps, serrated adenomas, tubular adenomas, or adenocarcinomas each served as separate outcome variables. Patient ethnicity was determined using a name-based computer algorithm. Demographic (age, sex, ethnicity) and a variety of socioeconomic risk factors (associated with patients’ ZIP code) served as predictor variables. Results: About 50% of the study population harbored adenomatous polyps, 25% hyperplastic polyps, 8% serrated adenomas, and 1.4% adenocarcinomas. Tubular adenomas and adenocarcinomas showed similar ethnic distributions, being slightly more common among Hispanics and East Asians. All four types of colonic neoplasm were relatively rare among patients of Asian-Indian descent and relatively common among patients of Japanese descent. Except for Japanese patients, serrated adenomas tended to be less prevalent among East Asians. In general, markers of high socioeconomic status showed a tendency to be negatively associated with the presence of tubular adenoma and adenocarcinoma, but positively with the presence of serrated adenoma. Conclusion: Ethnicity and socioeconomic factors affect different histology types of polyps differently. Genetic as well as environmental factors interact in the development of colorectal cancer and its precursor lesions.
AB - Background and aims: With the exception of African Americans and Hispanics, few studies have dealt with the influence of other types of ethnicity on the prevalence of colon polyps and colorectal cancer. The present study was undertaken to compare the ethnic and socioeconomic distributions of colonic neoplasms among different ethnic groups in the United States. Methods: A total of 813,057 patients, who underwent colonoscopy during 2008–2014, were recruited from an electronic database of histopathology reports (Miraca Life Sciences) for a cross-sectional study. Using multivariate logistic regression analyses, the presence of hyperplastic polyps, serrated adenomas, tubular adenomas, or adenocarcinomas each served as separate outcome variables. Patient ethnicity was determined using a name-based computer algorithm. Demographic (age, sex, ethnicity) and a variety of socioeconomic risk factors (associated with patients’ ZIP code) served as predictor variables. Results: About 50% of the study population harbored adenomatous polyps, 25% hyperplastic polyps, 8% serrated adenomas, and 1.4% adenocarcinomas. Tubular adenomas and adenocarcinomas showed similar ethnic distributions, being slightly more common among Hispanics and East Asians. All four types of colonic neoplasm were relatively rare among patients of Asian-Indian descent and relatively common among patients of Japanese descent. Except for Japanese patients, serrated adenomas tended to be less prevalent among East Asians. In general, markers of high socioeconomic status showed a tendency to be negatively associated with the presence of tubular adenoma and adenocarcinoma, but positively with the presence of serrated adenoma. Conclusion: Ethnicity and socioeconomic factors affect different histology types of polyps differently. Genetic as well as environmental factors interact in the development of colorectal cancer and its precursor lesions.
KW - Colon polyps
KW - colorectal cancer
KW - demographic characteristics
KW - environmental epidemiology
KW - socioeconomic risk factors
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U2 - 10.1177/2050640616666942
DO - 10.1177/2050640616666942
M3 - Article
C2 - 28507755
AN - SCOPUS:85019046030
SN - 2050-6406
VL - 5
SP - 424
EP - 431
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 3
ER -