Blacks Have Greater Risk for Larger, Difficult-To-Detect Colon Polyps Than Whites, Study Finds
Blacks are at higher risk than whites for having large precancerous polyps in their colons, according to a study published in this week's Journal of the American Medical Association, Reuters reports. Previous research has shown that blacks have higher prevalence of and mortality from colon cancer than whites (Stern, Reuters, 9/23). For the report, lead researcher David Lieberman, a professor of medicine and chief of gastroenterology at Oregon Health and Science University, and colleagues looked at 5,464 blacks and 80,061 whites who had undergone a colonoscopy at 67 medical centers across the U.S.
Researchers found that 422 blacks, or 7.7%, had one or more polyps that were larger than nine millimeters, compared with about 5,000 whites, or 6.2%. The risk for having polyps of that size or larger was 62% higher for black women than white women. Black men had a 16% higher risk than white men of having polyps that size, according to the report (Gordon, HealthDay/U.S. News & World Report, 9/23). The polyps found in blacks also were more likely to be located in the upper region of the colon, where a sigmoidoscopy, which examines only the lower half of the colon, likely would not detect it. Lieberman said, "If this finding is confirmed in other studies, consideration should be given to initiation of screening before age 50 years in black women," adding, "These data strongly emphasize the importance of timely screening in black women and men" (Reuters, 9/23).
Lieberman said, "Previous studies have suggested these differences may be from a lack of access to health care, or a failure of doctors to recommend screening, or a failure of the patients to follow through on screening. But, since we took a look at patients who were already getting screening exams, access and adherence weren't an issue, and we found that black men and women had more serious polyps."
Otis Brawley, chief medical officer at the American Cancer Society, noted that the study did not use a control group or take into account previous screening tests or socioeconomic status of the participants, which he says could have resulted in different conclusions.
He said, "It may be that colon cancer is more aggressive in blacks than in whites," but the issue needs to be studied further (HealthDay/U.S. News & World Report, 9/23).
An abstract of the study is available online. An extract of an editorial responding to the study also is available online.