Black Americans have a higher occurrence of colon polyps, according to a new study. This is a significant finding considering the incidence of colon cancer among black men has increased and remained unchanged among black women during the last 20 years.
The article will be published in the Sept. 24, issue of JAMA (Journal of the American Medical Association).
The new study, led by David A. Lieberman, M.D., head of gastroenterology, Oregon Health & Science University School of Medicine and Portland VA Medical Center, measured the incidence and location of colon polyps that were more than 9 mm in diameter, about the size of a pencil eraser, in men and women of all age groups who had undergone colonoscopy screenings at 67 sites across the United States.
Lieberman and colleagues found that of 5,464 black patients and 80,061 white patients who had undergone a colonoscopy, 7.7 percent (422) black patients and 6.2 percent of white patients (4,964) had at least one or more polyps larger than 9 mm. Black men had a 16 percent greater chance of having polyps larger than 9 mm, while black women had a 62 percent greater chance.
“These data show that Blacks who receive screening are more likely to have serious polyps, compared to Whites, and are therefore likely to benefit from more intensive screening. Black men and women age 50 years and older should be strongly encouraged to receive colon cancer screening,” said Lieberman, who also is co-director of the OHSU Digestive Health Center at the Center for Health & Healing and a member of the OHSU Cancer Institute.
According to the researchers, colorectal cancer prevalence and death are higher among black patients. Death rates for black men and women are 38 percent to 43 percent higher than for white men and women, and incidence rates are 15.5 percent to 23 percent higher in black individuals.
Lieberman and colleagues published the first large study using colonoscopy for colon cancer screening (New England Journal of Medicine, 2000), and demonstrated the limitations of other screening tests, such as fecal occult blood test and sigmoidoscopy (New England Journal of Medicine, 2001), and office fecal testing (Annals of Internal Medicine, 2005). Since these publications, colonoscopy has become the most commonly used colon screening test in the United States and has contributed to the reduction in both incidence and mortality during the past few years.
This work was supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases, a branch of the National Institutes of Health, and funding from AstraZenaca.
Oregon Health & Science University is the state’s only health and research university, and Oregon’s only academic health center. OHSU is Portland's largest employer and the fourth largest in Oregon (excluding government), with 12,400 employees. OHSU's size contributes to its ability to provide many services and community support activities not found anywhere else in the state. It serves patients from every corner of the state, and is a conduit for learning for more than 3,400 students and trainees. OHSU is the source of more than 200 community outreach programs that bring health and education services to every county in the state.
As a leader in research, OHSU earned $307 million in research funding in fiscal year 2007. OHSU serves as a catalyst for the region's bioscience industry and is an incubator of discovery, averaging one new breakthrough or innovation every three days, with more than 4,100 research projects currently under way. OHSU disclosed 132 inventions in 2007 alone, and OHSU research resulted in 33 new spinoff companies since 2000, most of which are based in Oregon.
About the OHSU Cancer Institute
The OHSU Cancer Institute is the only National Cancer Institute-designated center between Sacramento and Seattle. It comprises some 200 clinical researchers, basic scientists and population scientists who work together to translate scientific discoveries into longer and better lives for Oregon's cancer patients. In the lab, basic scientists examine cancer cells and normal cells to uncover molecular abnormalities that cause the disease. This basic science informs more than 300 clinical trials conducted at the OHSU Cancer Institute.
About the Portland Veterans Affairs Medical Center
The Portland VA Medical Center (PVAMC) provides quality primary and specialty medical care to more than 60,000 veterans and is the leading VA research institution for the state of Oregon and one of the largest VA research centers nationally. The program has 110 funded investigators. PVAMC has received a number of large grants to establish centers dedicated to the fight against important diseases. These include the Alcohol Research Center, the Northwest Veterans Affairs Cancer Research Center, National Center for Rehabilitative Auditory Research, Mental Illness Research Education and Clinical Center, Parkinson’s Disease Research, Education & Clinical Center, the Mood Disorders Center, Methamphetamine Abuse Research Center, Center for Study of Chronic Co-Morbid Mental and Physical Disorders, the Agency for Healthcare Research and Quality (AHRQ) Decision Science Center, and Research Enhancement Award Programs in Multiple Sclerosis, Hepatitis C and Health Services Research.