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Afro-Caribbeans Have a Lower Prevalence of Advanced Colon Neoplasia than African-Americans

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Abstract

Background/Aims

The black population in the USA is a heterogeneous group composed of smaller subgroups from different origins. The definition of black in many colorectal cancer (CRC) risk studies is vague, and differences in CRC risk comparing black subpopulations have not been evaluated. The aim of the study is to compare advanced colorectal neoplasia (ACN) between two subgroups of black populations: African-American (AA) and Afro-Caribbean (AC). A secondary aim was to determine whether there are differences in prevalence of adenomas.

Methods

This was a retrospective study of 3797 AA and AC patients undergoing first time screening colonoscopy in two different institutions in the USA.

Results

Overall adenoma prevalence was 29.3% for the entire population with 29.5% in AAs and 29.0% in AC with no statistically significant difference between the study groups (AOR: 1.02; 95% CI 0.88–1.18, P = 0.751). However, ACN was significantly higher in the AA group (11.8%) compared to AC (9.0%) (AOR: 1.30, 95% CI 1.02–1.66, P = 0.034). It was observed that AAs had ACN at a higher BMI than AC. After adjusting for BMI/ethnicity interactions, the difference in ACN between both groups became more significant (AOR: 1.93, 95% CI 1.16–3.23, P = 0.012).

Conclusions

AAs have a higher risk of ACN than AC. Current recommendations to start screening in average-risk AAs at an earlier age may not apply to other black subgroups.

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Abbreviations

AA:

African-American

AC:

Afro-Caribbean

ADR:

Adenoma detection rate

ACN:

Advanced colorectal neoplasia

CRC:

Colorectal cancer

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Funding

No funding was received in support of this work.

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Authors and Affiliations

  1. Department of Gastroenterology, Cleveland Clinic, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA

    Jose Melendez-Rosado, Katia Rodriguez, Harjinder Singh, Kiranmayee Kandragunta, Adalberto Gonzalez, Fayssa Salomon, Ishtiaq Hussain, Kanwarpreet Tandon & Fernando J. Castro

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  1. Jose Melendez-Rosado
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  2. Katia Rodriguez
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  3. Harjinder Singh
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  4. Kiranmayee Kandragunta
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Contributions

JMR contributed to the conception and design, experiments, collection, analysis and interpretation of data, drafting and critical revision of the article, and generation of figures. KR contributed to data collection. AG contributed to data collection and manuscript editing. HS contributed to data collection. KK contributed to data collection. FS contributed to data collection. IH contributed to data collection. KT contributed to data collection. FJC RJB contributed to the conception and design, experiments, collection, analysis and interpretation of data, drafting and critical revision of the article, and generation of figures. All authors approved the final draft of the article.

Corresponding author

Correspondence to Fernando J. Castro.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Melendez-Rosado, J., Rodriguez, K., Singh, H. et al. Afro-Caribbeans Have a Lower Prevalence of Advanced Colon Neoplasia than African-Americans. Dig Dis Sci 65, 2412–2418 (2020). https://doi.org/10.1007/s10620-019-05956-1

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  • DOI: https://doi.org/10.1007/s10620-019-05956-1

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