Prevalence of Metachronous Advanced Colorectal Neoplasia in Black and White Patients at a Safety Net Hospital
Background and Aims: Current postpolypectomy surveillance guidelines are based primarily on data from non-Hispanic Whites (NHWs); thus, generalizability to non-Hispanic Blacks (NHBs) remains unknown. Hence, the primary objective of this study was to assess the validity of these guidelines for NHBs b...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Gastro Hep Advances |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772572321000066 |
| _version_ | 1811208697548898304 |
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| author | Dionne Rebello Paul C. Schroy, III Anna Leszcynski Alessandro Colletta Elliott Rebello Justin Mills Timothy Heeren Hemant Roy |
| author_facet | Dionne Rebello Paul C. Schroy, III Anna Leszcynski Alessandro Colletta Elliott Rebello Justin Mills Timothy Heeren Hemant Roy |
| author_sort | Dionne Rebello |
| collection | DOAJ |
| description | Background and Aims: Current postpolypectomy surveillance guidelines are based primarily on data from non-Hispanic Whites (NHWs); thus, generalizability to non-Hispanic Blacks (NHBs) remains unknown. Hence, the primary objective of this study was to assess the validity of these guidelines for NHBs by comparing the prevalence of metachronous advanced colorectal neoplasia (ACN) between NHWs and NHBs undergoing surveillance colonoscopy. Methods: This was a retrospective cross-sectional study of NHWs (N = 1500) and NHBs (N = 1260) aged 40–75 years who underwent surveillance colonoscopy at an academic safety net hospital between 2007 and 2017. The primary outcome measure was the prevalence of metachronous ACN, defined as an advanced adenoma, advanced sessile polyp, or invasive cancer. Multivariate logistic regression was used to measure associations between race/ethnicity and ACN prevalence after adjustment for potential confounding factors. Results: Overall, the prevalence of metachronous ACN was similar for NHBs and NHWs (6.8% vs 7.4%, respectively; P = .60). The prevalence of metachronous cancers (0.2% vs 0.1%; P = .48), advanced adenomas (2.8% vs 3.8%; P = .14), advanced serrated polyps (3.5% vs 3.3%; P = .82), and large hyperplastic polyps ≥10 mm (0.2% vs 0.6%, P = .24) were also similar between the 2 groups. Moreover, race was not a determinant of metachronous ACN after adjustment for age, sex, education, type of insurance, indication (screen/surveillance) for baseline colonoscopy, surveillance interval, and findings at baseline colonoscopy (adjusted odds ratio, 0.96; 95% confidence interval, 0.70–1.30; P = .78). Conclusion: Our study finds no significant difference in the prevalence of metachronous ACN between NHWs and NHBs undergoing appropriate postpolypectomy surveillance at an urban safety net hospital, suggesting that current guidelines are appropriate for both NHWs and NHBs. |
| first_indexed | 2024-04-12T04:25:57Z |
| format | Article |
| id | doaj.art-b254c34a1ba844f3b74b5a30bb71585c |
| institution | Directory Open Access Journal |
| issn | 2772-5723 |
| language | English |
| last_indexed | 2024-04-12T04:25:57Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gastro Hep Advances |
| spelling | doaj.art-b254c34a1ba844f3b74b5a30bb71585c2022-12-22T03:48:05ZengElsevierGastro Hep Advances2772-57232022-01-01111422Prevalence of Metachronous Advanced Colorectal Neoplasia in Black and White Patients at a Safety Net HospitalDionne Rebello0Paul C. Schroy, III1Anna Leszcynski2Alessandro Colletta3Elliott Rebello4Justin Mills5Timothy Heeren6Hemant Roy7Section of Gastroenterology, Boston University School of Medicine, Boston, MassachusettsSection of Gastroenterology, Boston University School of Medicine, Boston, Massachusetts; Correspondence: Address correspondence to: Paul C. Schroy III, MD, MPH, Boston Medical Center, 85 E. Concord St., Suite 7715, Boston, Massachusetts 02118; fax: (617) 638-6525.Section of Gastroenterology, Boston University School of Medicine, Boston, MassachusettsSection of Gastroenterology, Boston University School of Medicine, Boston, MassachusettsAlpert Medical School of Brown University, Providence, Rhode IslandTufts University, Medford, MassachusettsDepartment of Biostatistics, Boston University School of Public Health, Boston, MassachusettsSection of Gastroenterology, Boston University School of Medicine, Boston, MassachusettsBackground and Aims: Current postpolypectomy surveillance guidelines are based primarily on data from non-Hispanic Whites (NHWs); thus, generalizability to non-Hispanic Blacks (NHBs) remains unknown. Hence, the primary objective of this study was to assess the validity of these guidelines for NHBs by comparing the prevalence of metachronous advanced colorectal neoplasia (ACN) between NHWs and NHBs undergoing surveillance colonoscopy. Methods: This was a retrospective cross-sectional study of NHWs (N = 1500) and NHBs (N = 1260) aged 40–75 years who underwent surveillance colonoscopy at an academic safety net hospital between 2007 and 2017. The primary outcome measure was the prevalence of metachronous ACN, defined as an advanced adenoma, advanced sessile polyp, or invasive cancer. Multivariate logistic regression was used to measure associations between race/ethnicity and ACN prevalence after adjustment for potential confounding factors. Results: Overall, the prevalence of metachronous ACN was similar for NHBs and NHWs (6.8% vs 7.4%, respectively; P = .60). The prevalence of metachronous cancers (0.2% vs 0.1%; P = .48), advanced adenomas (2.8% vs 3.8%; P = .14), advanced serrated polyps (3.5% vs 3.3%; P = .82), and large hyperplastic polyps ≥10 mm (0.2% vs 0.6%, P = .24) were also similar between the 2 groups. Moreover, race was not a determinant of metachronous ACN after adjustment for age, sex, education, type of insurance, indication (screen/surveillance) for baseline colonoscopy, surveillance interval, and findings at baseline colonoscopy (adjusted odds ratio, 0.96; 95% confidence interval, 0.70–1.30; P = .78). Conclusion: Our study finds no significant difference in the prevalence of metachronous ACN between NHWs and NHBs undergoing appropriate postpolypectomy surveillance at an urban safety net hospital, suggesting that current guidelines are appropriate for both NHWs and NHBs.http://www.sciencedirect.com/science/article/pii/S2772572321000066Colorectal CancerColorectal PolypsSurveillanceHealthcare Disparities |
| spellingShingle | Dionne Rebello Paul C. Schroy, III Anna Leszcynski Alessandro Colletta Elliott Rebello Justin Mills Timothy Heeren Hemant Roy Prevalence of Metachronous Advanced Colorectal Neoplasia in Black and White Patients at a Safety Net Hospital Gastro Hep Advances Colorectal Cancer Colorectal Polyps Surveillance Healthcare Disparities |
| title | Prevalence of Metachronous Advanced Colorectal Neoplasia in Black and White Patients at a Safety Net Hospital |
| title_full | Prevalence of Metachronous Advanced Colorectal Neoplasia in Black and White Patients at a Safety Net Hospital |
| title_fullStr | Prevalence of Metachronous Advanced Colorectal Neoplasia in Black and White Patients at a Safety Net Hospital |
| title_full_unstemmed | Prevalence of Metachronous Advanced Colorectal Neoplasia in Black and White Patients at a Safety Net Hospital |
| title_short | Prevalence of Metachronous Advanced Colorectal Neoplasia in Black and White Patients at a Safety Net Hospital |
| title_sort | prevalence of metachronous advanced colorectal neoplasia in black and white patients at a safety net hospital |
| topic | Colorectal Cancer Colorectal Polyps Surveillance Healthcare Disparities |
| url | http://www.sciencedirect.com/science/article/pii/S2772572321000066 |
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