Can the rate and location of sessile serrated polyps be part of colorectal Cancer disparity in African Americans?
Black or African American
/ statistics & numerical data
Aged
Colon, Ascending
Colon, Sigmoid
Colon, Transverse
Colonic Polyps
/ diagnostic imaging
Colonoscopy
Colorectal Neoplasms
/ diagnostic imaging
Female
Health Status Disparities
Humans
Male
Middle Aged
Rectum
Retrospective Studies
United States
/ epidemiology
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
24 May 2019
24 May 2019
Historique:
received:
24
11
2018
accepted:
16
05
2019
entrez:
26
5
2019
pubmed:
28
5
2019
medline:
18
12
2019
Statut:
epublish
Résumé
Up to 30% of colorectal cancers develop through the serrated pathway. African Americans (AAs) suffer a disproportionate burden of colorectal cancer. The aim of this study was to evaluate clinicopathological features of AA patients diagnosed with sessile serrated polyps (SSPs). We conducted a retrospective study of all colonoscopies (n = 12,085) performed at Howard University Hospital, from January 1st, 2010 to December 31st, 2015, of which 83% were in AA patients, (n = 10,027). Among AAs, pathology reports confirmed 4070 patients with polyps including 252 with SSPs. Demographic and clinical variables (i.e. sex, age, BMI, anatomic location, clinical symptoms, polyp size, and clinical indications were collected at colonoscopy. In the AA population, the median age was 56 with interquartile range (IQR) of 51 to 62 years, 54% were female, and 48% had a BMI > 30. The most common reason for colonoscopy was screening (53%), whereas the prevalent reasons for diagnostic colonoscopies were changes in bowel habits (18%) and gastrointestinal bleeding (17%). The total number of SSPs among the 252 AA (diagnosed with SSPs) was 338. Of these, 9% (n = 29/338) had some degree of cytological dysplasia, primarily in the ascending colon (n = 6/42, 14%), Transverse colon (n = 2/16, 13%) and rectosigmoid (n = 19/233, 8%). About 24% of patients had more than 2 polyps. Most patients (76%) had distal SSPs (rectal and rectosigmoid), in comparison to 14% of proximal polyps and 10% of bilateral locations. Median SSA/P size for all locations was 0.6 cm. The prevalence of SSPs accounts for 6% of all polyps in AA patients and was diagnosed in 2.5% of all colonoscopies (n = 252/10,027), which is higher than Caucasians in the US. SSPs were predominantly located in the left side, as compared to published literature showing the predominance in the right side of the colon. Screening of CRC will have the chance to detect high risk SSA/P in this population.
Sections du résumé
BACKGROUND
BACKGROUND
Up to 30% of colorectal cancers develop through the serrated pathway. African Americans (AAs) suffer a disproportionate burden of colorectal cancer. The aim of this study was to evaluate clinicopathological features of AA patients diagnosed with sessile serrated polyps (SSPs).
METHODS
METHODS
We conducted a retrospective study of all colonoscopies (n = 12,085) performed at Howard University Hospital, from January 1st, 2010 to December 31st, 2015, of which 83% were in AA patients, (n = 10,027). Among AAs, pathology reports confirmed 4070 patients with polyps including 252 with SSPs. Demographic and clinical variables (i.e. sex, age, BMI, anatomic location, clinical symptoms, polyp size, and clinical indications were collected at colonoscopy.
RESULTS
RESULTS
In the AA population, the median age was 56 with interquartile range (IQR) of 51 to 62 years, 54% were female, and 48% had a BMI > 30. The most common reason for colonoscopy was screening (53%), whereas the prevalent reasons for diagnostic colonoscopies were changes in bowel habits (18%) and gastrointestinal bleeding (17%). The total number of SSPs among the 252 AA (diagnosed with SSPs) was 338. Of these, 9% (n = 29/338) had some degree of cytological dysplasia, primarily in the ascending colon (n = 6/42, 14%), Transverse colon (n = 2/16, 13%) and rectosigmoid (n = 19/233, 8%). About 24% of patients had more than 2 polyps. Most patients (76%) had distal SSPs (rectal and rectosigmoid), in comparison to 14% of proximal polyps and 10% of bilateral locations. Median SSA/P size for all locations was 0.6 cm.
CONCLUSION
CONCLUSIONS
The prevalence of SSPs accounts for 6% of all polyps in AA patients and was diagnosed in 2.5% of all colonoscopies (n = 252/10,027), which is higher than Caucasians in the US. SSPs were predominantly located in the left side, as compared to published literature showing the predominance in the right side of the colon. Screening of CRC will have the chance to detect high risk SSA/P in this population.
Identifiants
pubmed: 31126232
doi: 10.1186/s12876-019-0996-y
pii: 10.1186/s12876-019-0996-y
pmc: PMC6534887
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
77Subventions
Organisme : NIMHD NIH HHS
ID : G12 MD007597
Pays : United States
Organisme : NIMHD NIH HHS
ID : U54 MD007597
Pays : United States
Organisme : NIH HHS
ID : G12MD007597
Pays : United States
Références
Chin J Cancer. 2015 Jun 10;34(9):384-93
pubmed: 26111811
Am J Gastroenterol. 2012 Sep;107(9):1315-29; quiz 1314, 1330
pubmed: 22710576
Dig Dis Sci. 2016 Jan;61(1):265-72
pubmed: 26386856
Gastroenterology. 2014 Aug;147(2):351-8; quiz e14–5
pubmed: 24786894
Gastrointest Endosc. 2017 Mar;85(3):590-600
pubmed: 27663716
World J Gastroenterol. 2009 Aug 14;15(30):3767-70
pubmed: 19673017
Int J Colorectal Dis. 2016 Feb;31(2):343-9
pubmed: 26510850
Dig Liver Dis. 2014 Feb;46(2):176-81
pubmed: 24054769
Am J Surg Pathol. 2003 Jan;27(1):65-81
pubmed: 12502929
J Gastroenterol Hepatol. 2013 Apr;28(4):608-12
pubmed: 23278321
Gastrointest Endosc. 2013 Apr;77(4):617-23
pubmed: 23321338
Clin Gastroenterol Hepatol. 2013 Jul;11(7):760-7; quiz e54-5
pubmed: 23267866
Dig Liver Dis. 2015 Feb;47(2):95-102
pubmed: 25445408
Colorectal Dis. 2012 Nov;14(11):1323-7
pubmed: 22390284
World J Gastroenterol. 2010 Jul 21;16(27):3402-5
pubmed: 20632442
Mod Pathol. 2003 May;16(5):417-23
pubmed: 12748247
Cancer Prev Res (Phila). 2016 Jun;9(6):456-65
pubmed: 27026680
Endoscopy. 2016 Aug;48(8):740-6
pubmed: 27110696
CA Cancer J Clin. 2016 Jul;66(4):290-308
pubmed: 26910411
Int J Cancer. 2016 Mar 15;138(6):1472-81
pubmed: 26476272
Med Arch. 2016 Jun;70(3):198-202
pubmed: 27594746
Gastroenterology. 2014 Apr;146(4):950-60
pubmed: 24417818
Am J Gastroenterol. 2010 Dec;105(12):2656-64
pubmed: 20717107
Gastroenterology. 2012 Sep;143(3):844-857
pubmed: 22763141
J Gastroenterol Hepatol. 2017 Feb;32(2):358-367
pubmed: 27376251
World J Gastrointest Endosc. 2015 Jul 25;7(9):860-71
pubmed: 26240687
Chin Med J (Engl). 2016 20th Oct;129(20):2427-2433
pubmed: 27748334
Gastrointest Endosc. 2015 Mar;81(3):517-24
pubmed: 24998465
Colorectal Dis. 2016 Aug;18(8):795-802
pubmed: 26784017
Gastrointest Endosc. 2018 Mar;87(3):755-765.e1
pubmed: 28843582
Am J Gastroenterol. 2009 Mar;104(3):739-50
pubmed: 19240699
Dis Colon Rectum. 2011 Feb;54(2):164-70
pubmed: 21228663
Am J Surg Pathol. 1990 Jun;14(6):524-37
pubmed: 2186644
J Pathol. 2001 Mar;193(3):286-94
pubmed: 11241406
Gastroenterology. 2006 Nov;131(5):1400-7
pubmed: 17101316
Am J Surg Pathol. 2008 Jan;32(1):30-5
pubmed: 18162767
J Clin Pathol. 2010 Aug;63(8):681-6
pubmed: 20547691
World J Gastroenterol. 2006 May 7;12(17):2770-2
pubmed: 16718767
World J Gastroenterol. 2014 Mar 14;20(10):2634-40
pubmed: 24627599
CA Cancer J Clin. 2016 Jan-Feb;66(1):7-30
pubmed: 26742998
Virchows Arch. 2010 Sep;457(3):291-7
pubmed: 20617338
Ann Chir Gynaecol. 1991;80(1):30-5
pubmed: 1888110
Int J Cancer. 2016 Apr 1;138(7):1634-44
pubmed: 26510091
Gastrointest Endosc. 2013 Mar;77(3):360-75
pubmed: 23410696
Cancer Epidemiol Biomarkers Prev. 2009 Aug;18(8):2310-7
pubmed: 19661090
Am J Surg Pathol. 1984 Jul;8(7):551-6
pubmed: 6742315
Clin Gastroenterol Hepatol. 2016 Jul;14(7):1056-9
pubmed: 26898652
Histopathology. 2005 Jul;47(1):32-40
pubmed: 15982321
J Natl Med Assoc. 2007 Jul;99(7):723-8
pubmed: 17668638
Exp Ther Med. 2011 Jul;2(4):695-700
pubmed: 22977561
Gastroenterol Res Pract. 2019 Feb 06;2019:1592306
pubmed: 30881445
Clin Gastroenterol Hepatol. 2016 Aug;14(8):1155-62
pubmed: 27060426
Clin Gastroenterol Hepatol. 2011 Jan;9(1):42-6
pubmed: 20888435
Histopathology. 2010 Apr;56(5):581-8
pubmed: 20459568
Genes Chromosomes Cancer. 2019 Jan;58(1):23-33
pubmed: 30265426
Am J Epidemiol. 2013 Apr 1;177(7):625-37
pubmed: 23459948
Curr Gastroenterol Rep. 2008 Oct;10(5):490-8
pubmed: 18799125
Gastroenterology. 2018 Dec;155(6):1776-1786.e1
pubmed: 30142339
PLoS One. 2014 Feb 12;9(2):e88367
pubmed: 24533081
BMC Cancer. 2014 Jun 25;14:466
pubmed: 24964857
Gastroenterology. 2003 Feb;124(2):544-60
pubmed: 12557158
Transl Oncol. 2014 Aug;7(4):456-63
pubmed: 24954356