The association of age and race and the risk of large bowel polyps
A partir des données de trois essais contrôlés (2 605 participants), cette étude américaine évalue les disparités ethniques dans le risque d'adénomes colorectaux métachrones et de polypes intestinaux, en fonction de l'âge du patient
Background: Blacks have a higher incidence of colorectal cancer (CRC) and a younger age at diagnosis compared to Whites. Few studies have investigated racial differences in risk of metachronous adenomas and serrated polyps whether this risk differs by polyp characteristics or age of patient. Methods: We analyzed data pooled from three placebo-controlled adenoma chemoprevention trials to explore racial differences in the risk of large bowel polyps in patients ≤50 and > 50 years of age. Using generalized linear regression, we estimated risk ratios (RR) and 95% confidence intervals (CI) as measures of the association between race and risk of one or more adenomas or serrated polyps after randomization. Results: Among the 2605 subjects who completed at least one follow-up exam, blacks ≤50 years of age had a higher risk of any conventional adenoma (RR 1.70, 95% CI 0.99-2.92) and advanced neoplasms (RR 4.05, 95% CI 1.43-11.46) and a non-significantly lower risk of serrated polyps (RR 0.75 (95% CI 0.34-1.62) compared to whites. Among patients > 50 years there was no racial difference in risk of adenomas (RR 1.08, 95% CI 0.92-1.27) or advanced neoplasms (RR 1.05, 95% CI 0.71- 1.56)). However, blacks had a significantly lower risk of serrated polyps (RR 0.65, 95% CI 0.49-0.87) than whites. Conclusions: Our results demonstrate a higher risk of metachronous adenomas in blacks compared to whites at younger ages. Impact: Our results suggest that the racial disparity in CRC incidence may be due to an excess of neoplasia in younger blacks.