DDW Studies Address Colorectal Cancer Screening by Ethnicity and Screening Strategy

Several studies presented at Digestive Disease Week examined the adherence to colorectal cancer screening, including colonoscopy and fecal occult blood testing, by ethnicity and recommended screening strategy, according to a DDW news release.

The first study, by researchers at the University of California, San Francisco, found disparities in CRC mortality existing between racial and ethnic groups. The study also found that CRC mortality could be reduced by screening using both FOBT and colonoscopy.

Researchers followed nearly 1,000 patients at average CRC risk who received a recommendation from a primary care provider for FOBT alone, colonoscopy alone or a choice between the two. To reduce system barriers, including access and limited English proficiency, patient costs of colonoscopy were decreased or eliminate, prep instructions were provided in the patient's preferred language and transportation was provided if needed, according to the report. Appointments were scheduled within two weeks of the recommendation.

The study found that 65.1 percent of patients adhered to any type of CRC strategy. However, significant differences in adherence existed based on racial and ethnic groups: Asians (73 percent) and Latinos (70 percent) adhered more often than Caucasians (62 percent) or African Americans (51 percent), according to the release.

A second study from Brooklyn Hospital Center, highlighted the need for increased CRC screening guidelines in adults 75 years and older, as researchers found high adenoma detection rates in asymptomatic elderly African American and Hispanic patients.

Researchers examined the colonoscopy results of 510 elderly African American, Hispanic American and Asian American patients. Patients with a prior history of advanced adenomas or CRC were more likely to have adenomas detected compared with those with no prior history, according to the release.

Detection rates of both adenomas and CRC were most significant in the African American population, which had 20.1 percent adenoma detection rates and 2.3 percent CRC detection, according to the release.

A third study further investigated the presence of high-grade dysplasia in younger African Americans (45-49 years old) compared with older patients (50-59 years), leading to the recommendation that the younger population should be screened for CRC, according to the release.

Researchers from Temple University in Philadelphia examined the results of screening by colonoscopy of African Americans at their institution and comparing the results of those ages 45 to 49 with those ages 50 to 59. Their study of 335 African Americans found adenomatous polyps in 22.3 percent of the younger cohort compared to 19.7 percent of the older cohort, according to the release. Of the polyps found, 4.5 percent showed high-grade dysplasia in the younger group compared to 0.4 percent in the older group.

Researchers also found that patients in the older group were more likely to consume aspirin daily compared to their younger counterparts (26.1 percent vs. 13.5 percent), which may have contributed to their lower incidence of polyps since aspirin is known to be a protective measure against CRC, according to the release.

Read the DDW release on colorectal cancer screening in diverse populations.