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African American Race Not a Factor in Decision to Undergo First-Time Colorectal Cancer Screening in Elderly Men: Presented at ACG

By Bruce Sylvester

SAN DIEGO -- October 29, 2009 -- For elderly men between the ages of 75 and 85, race should not affect the decision about getting a first-time colorectal cancer screening, researchers reported here at the American College of Gastroenterology (ACG) 74th Annual Scientific Meeting.

"African American race is considered a risk factor for colorectal cancer … in patients of a younger age, prompting the recommendation to initiate screening at age 45 in those patients," stated lead investigator Frederick Harris, Jr, MD, University of Tennessee Health Sciences Center, Memphis, Tennessee. "This increased risk was not seen in our study of asymptomatic males age 75 to 85 who presented for first-time screening," he added, speaking at his poster presentation here on October 27.

Dr. Harris and his fellow investigators conducted a retrospective review of all outpatient screening colonoscopies performed at the Memphis Veteran's Administration Center from 2006 through 2008.

The investigators excluded women, male patients under 75 years of age or over 85 years of age, nursing-home residents, those who had undergone any prior colorectal cancer screening of any sort, and also those who had had a colonoscopy for any other reason than for colorectal cancer screening (blood per rectum, iron deficiency, abdominal pain, constipation, diarrhoea, or abnormal imaging).

Advanced lesions were defined as an adenoma of 1 cm or greater, or those containing villous pathology.

Standard statistical analysis was used to determine the significance of the findings.

The researchers identified 109 patients who met all selection criteria: 68 white males and 41 African American males. They found that whites showed a statistically significantly higher prevalence of polyps (79.4% vs 56.1%, P = .016). Whites also showed a higher prevalence of adenomas (61.8% vs 48.8%, P > .05).

Rates for advanced lesions were similar for whites versus African Americans (17.6% vs 19.5%, P > .05), and adenocarcinoma rates were similar for both races (2.9% vs 4.9%, P > .05).

The investigators noted that 96% of the African American subjects with polyps had neoplastic pathology, compared with an 81% rate among the white subjects.

"Thus, a patient's race should not be part of the individualised decision for first-time screening of males ages 75 to 85," said Dr. Harris.

[Presentation title: First-Time Colorectal Cancer Screening in Males Ages 75-85: Is African American Race an Important Risk Factor? Abstract 1225]

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