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Race/Ethnicity-Specific Disparities in the Severity of Disease at Presentation in Adults with Ulcerative Colitis: A Cross-Sectional Study

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Abstract

Background

While ulcerative colitis (UC) is well studied in Caucasian populations, less data are available on UC patients of racial/ethnic minorities, including variations in disease severity at presentation.

Aim

To evaluate race/ethnicity-specific disparities in UC disease presentation among an ethnically diverse underserved population.

Methods

We performed a cross-sectional study of all consecutive UC adults among a large ethnically diverse safety-net hospital from July 2014 to May 2016 to compare race/ethnicity-specific disparities in severity of disease at presentation. Severity was evaluated using the clinician-based simple clinical colitis activity index (SCCAI) and the Mayo score at time of presentation. Multivariate ordered logistic regression models were used to evaluate associations with SCCAI and Mayo scores.

Results

Among 98 UC patients (56.1% male, mean age 40.1 (SD 14.2), 32.0% were African-American, 26.7% Hispanic, 16.0% Asian, and 20.0% Caucasian. Mean Mayo score was 6.6 and mean SCCAI score was 6.5. When stratified by race/ethnicity, SCCAI scores were significantly higher in non-Caucasians compared to Caucasians (7.0 vs 4.6, p = 0.03) and in Asians compared to Caucasians (8.0 vs 4.6, p = 0.02). There was a trend toward higher mean SCCAI in Hispanics compared to Caucasians (6.9 vs 4.6, p = 0.07). Mayo scores at presentation demonstrated similar trends. On multivariate logistic regression, Asians (OR 5.26, 95% CI 1.24–22.42) and Hispanics (OR 3.74; 95% CI 1.02–13.66) had more severe disease at presentation than Caucasians based on SCCAI.

Conclusions

Among a diverse underserved cohort of UC patients, racial/ethnic minority patients with UC, specifically Asians and Hispanics, had more severe disease at presentation compared to Caucasians. The differences may reflect disparities in timely access to specialty care and treatment and deserves greater attention and research.

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Abbreviations

SCCAI:

Simple clinical colitis activity index

UC:

Ulcerative colitis

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Authors and Affiliations

  1. Department of Medicine, Alameda Health System – Highland Hospital, Oakland, CA, USA

    Garland Castaneda

  2. Division of Gastroenterology and Hepatology, Alameda Health System – Highland Hospital, 1411 East 31st Street, Highland Hospital – Highland, Care Pavilion 5th Floor, Endoscopy Unit, Oakland, CA, 94602, USA

    Benny Liu, Sharon Torres, Taft Bhuket & Robert J. Wong

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  1. Garland Castaneda
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  2. Benny Liu
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  3. Sharon Torres
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Corresponding author

Correspondence to Robert J. Wong.

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The authors of this manuscript have no conflicts of interest to disclose as described by Digestive Diseases and Sciences.

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Castaneda, G., Liu, B., Torres, S. et al. Race/Ethnicity-Specific Disparities in the Severity of Disease at Presentation in Adults with Ulcerative Colitis: A Cross-Sectional Study. Dig Dis Sci 62, 2876–2881 (2017). https://doi.org/10.1007/s10620-017-4733-5

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  • DOI: https://doi.org/10.1007/s10620-017-4733-5

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