Advertisement

Digestive Diseases and Sciences

, Volume 64, Issue 1, pp 232–240 | Cite as

Differences in Prevalence of Large Polyps Between Hispanic Americans from Mexican- and Non-Mexican-Predominant States

  • Danny J. Avalos
  • Marc J. Zuckerman
  • Alok Dwivedi
  • Christopher Dodoo
  • Jinendra Satiya
  • Fernando J. Castro
Original Article

Abstract

Background

There have been conflicting reports comparing the prevalence of large polyps (>9 mm) between Hispanics and non-Hispanic whites (NHW). Differences between Hispanic subpopulations may account for these variations.

Aims

We aimed to assess the prevalence of large polyps (>9 mm) in Hispanics from Mexican- and non-Mexican-predominant states compared with NHW. As secondary outcome, we evaluated results by polyp location.

Methods

The 2010 U.S. Census Bureau was used to identify states with a predominantly Mexican Hispanic (West) versus non-Mexican Hispanic (East) populations. Average-risk colonoscopies in those states from 2001 to 2014 were accessed using the Clinical Outcomes Research Initiative database. Military and Veteran’s Administration sites were excluded. Hispanics were compared with NHW in each geographical location using hierarchical logistic regression analysis.

Results

A total of 65,138 procedures were included with 33,425 procedures in the West (14.5% Hispanics) and 31,713 procedures in the East (44.0% Hispanics,). East Hispanics had significantly less odds of large polyps, OR 0.74, CI 0.58–0.94, p = 0.02, while West Hispanics exhibited no difference, OR 0.91, CI 0.76–1.10, p = 0.33, compared with NHW. Eastern Hispanics had less odds of large distal polyps, OR 0.69, CI 0.52–0.91, p = 0.01, and no difference in proximal polyps compared with NHW. Among Western Hispanics, no differences were seen in proximal, OR 1.06, CI 0.83–1.35, p = 0.66, or distal polyps, OR 0.83, CI 0.68–1.02, p = 0.08, compared with NHW.

Conclusion

Using NHW as a reference, Hispanics from Mexican-predominant states have a similar prevalence of large polyps, while Hispanics from non-Mexican-predominant states have a lower prevalence. Differences in Hispanic subpopulations likely explain previous conflicting reports on the prevalence of large polyps in Hispanics and NHW.

Keywords

Hispanic Americans Polyps Colonoscopy Prevalence 

Notes

Funding

Funding from NIDDK supports the collection, management, analysis, and interpretation of this and all CORI research. In addition, the practice network (CORI) has received support for the infrastructure of the practice-based network from AstraZeneca, Bard International, Pentax USA, ProVation, Endosoft, GIVEN Imaging, and Ethicon. The commercial entities had no involvement in this research.

Compliance with ethical standards

Conflict of interest

All authors have no personal conflict of interests to declare

References

  1. 1.
    American Cancer Society. Key Statistics for Colorectal Cancer. 2017. https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html. Accessed October 2, 2017
  2. 2.
    Rex DK, Boland CR, Dominitz JA, et al. Colorectal cancer screening: recommendations for physicians and patients from the U.S. multi-society task force on colorectal cancer. Am J Gastroenterol. 2017;112:1016–1030.CrossRefGoogle Scholar
  3. 3.
    U.S Census Bureau. FFF: Hispanic Heritage Month 2017. 2017. https://www.census.gov/newsroom/facts-for-features/2017/hispanic-heritage.html. Accessed January 2nd 2018
  4. 4.
    Siegel RL, Fedewa SA, Miller KD, et al. Cancer statistics for Hispanics/Latinos, 2015. CA Cancer J Clin. 2015;65:457–480.CrossRefGoogle Scholar
  5. 5.
    Lieberman DA, Williams JL, Holub JL, et al. Race, ethnicity, and sex affect risk for polyps >9 mm in average-risk individuals. Gastroenterology. 2014;147:351–358. (quiz e314–355).CrossRefGoogle Scholar
  6. 6.
    Lee B, Holub J, Peters D, et al. Prevalence of colon polyps detected by colonoscopy screening of asymptomatic Hispanic patients. Dig Dis Sci. 2012;57:481–488.  https://doi.org/10.1007/s10620-011-1898-1.CrossRefPubMedGoogle Scholar
  7. 7.
    US Census Bureau. The Hispanic Population: 2010. 2010. https://www.census.gov/prod/cen2010/briefs/c2010br-04.pdf. Accessed November 18, 2017
  8. 8.
    Dwivedi SN, Begum S, Dwived AK, et al. Community effects on public health in India: a hierarchical model. Health. 2012;04(08):4.CrossRefGoogle Scholar
  9. 9.
    Dwivedi SN, Begum S, Dwivedi AK, et al. Determinants of infant mortality in rural India: a three-level model. Health. 2013;05(11):8.CrossRefGoogle Scholar
  10. 10.
    Zheng XE, Li T, Lipka S, et al. Location-dependent ethnic differences in the risk of colorectal adenoma: a retrospective multiethnic study. J Clin Gastroenterol. 2014;48:e1–e7.CrossRefGoogle Scholar
  11. 11.
    Rodriguez EA, Tamariz L, Palacio A, et al. Racial disparities in the presentation and treatment of colorectal cancer: a statewide cross-sectional study. J Clin Gastroenterol. 2018;52:817–820.PubMedGoogle Scholar
  12. 12.
    Lebwohl B, Capiak K, Neugut AI, et al. Risk of colorectal adenomas and advanced neoplasia in Hispanic, black and white patients undergoing screening colonoscopy. Aliment Pharmacol Ther. 2012;35:1467–1473.CrossRefGoogle Scholar
  13. 13.
    Caribe CEpALye. Etnicidad, “Raza” Y Equidad En América Latinay El Caribe. http://repositorio.cepal.org/bitstream/handle/11362/31450/S008674_es.pdf?sequence=2. 2000; Accessed December 1, 2017
  14. 14.
    Hernandez-Suarez G, Sanabria MC, Serrano M, et al. Genetic ancestry is associated with colorectal adenomas and adenocarcinomas in Latino populations. Eur J Hum Genet. 2014;22:1208–1216.CrossRefGoogle Scholar
  15. 15.
    Stern MC, Zhang J, Lee E, et al. Disparities in colorectal cancer incidence among Latino subpopulations in California defined by country of origin. Cancer Causes Control. 2016;27:147–155.CrossRefGoogle Scholar
  16. 16.
    Savas LS, Vernon SW, Atkinson JS, et al. Effect of acculturation and access to care on colorectal cancer screening in low-income Latinos. J Immigr Minor Health. 2015;17:696–703.CrossRefGoogle Scholar
  17. 17.
    Hubert HB, Snider J, Winkleby MA. Health status, health behaviors, and acculturation factors associated with overweight and obesity in Latinos from a community and agricultural labor camp survey. Prev Med. 2005;40:642–651.CrossRefGoogle Scholar
  18. 18.
    O’Brien MJ, Alos VA, Davey A, et al. Acculturation and the prevalence of diabetes in US Latino Adults, National Health and Nutrition Examination Survey 2007–2010. Prev Chronic Dis. 2014;11:E176.CrossRefGoogle Scholar
  19. 19.
    Pinheiro PS, Sherman RL, Trapido EJ, et al. Cancer incidence in first generation U.S. Hispanics: Cubans, Mexicans, Puerto Ricans, and new Latinos. Cancer Epidemiol Biomark Prev. 2009;18:2162–2169.CrossRefGoogle Scholar
  20. 20.
    Pinheiro PS, Callahan KE, Stern MC, et al. Migration from Mexico to the united states: a high-speed cancer transition. Int J Cancer. 2017;142:477–488.CrossRefGoogle Scholar
  21. 21.
    Koblinski J, Jandova J, Nfonsam V. Disparities in incidence of early- and late-onset colorectal cancer between Hispanics and Whites: A 10-year SEER database study. Am J Surg. 2018;215:581–585.CrossRefGoogle Scholar
  22. 22.
    Centers for Disease Control and Prevention. Colorectal Cancer Rates by Race and Ethnicity. 2017. https://www.cdc.gov/cancer/colorectal/statistics/race.htm
  23. 23.
    Martinsen RP, Morris CR, Pinheiro PS, et al. Colorectal cancer trends in california and the need for greater screening of hispanic men. Am J Prev Med. 2016;51:e155–e163.CrossRefGoogle Scholar
  24. 24.
    Johnson-Kozlow M. Colorectal cancer screening of Californian adults of Mexican origin as a function of acculturation. J Immigr Minor Health. 2010;12:454–461.CrossRefGoogle Scholar
  25. 25.
    Lee KK, Jandorf L, Itzkowitz SH. Diminutive polyps among black and Latino populations undergoing screening colonoscopy: evidence supporting a resect and discard approach. Gastrointest Endosc. 2015;81:728–732.CrossRefGoogle Scholar
  26. 26.
    Lieberman D, Moravec M, Holub J, et al. Polyp size and advanced histology in patients undergoing colonoscopy screening: implications for CT colonography. Gastroenterology. 2008;135:1100–1105.CrossRefGoogle Scholar
  27. 27.
    Schoen RE, Weissfeld JL, Pinsky PF, et al. Yield of advanced adenoma and cancer based on polyp size detected at screening flexible sigmoidoscopy. Gastroenterology. 2006;131:1683–1689.CrossRefGoogle Scholar
  28. 28.
    Kaminski MF, Polkowski M, Kraszewska E, et al. A score to estimate the likelihood of detecting advanced colorectal neoplasia at colonoscopy. Gut. 2014;63:1112–1119.CrossRefGoogle Scholar
  29. 29.
    Zapatier J, Avalos D, Tandon K, et al. Can adjusting BMI for age and sex provide for a better predictor of colonic neoplasia? Eur J Gastroenterol Hepatol. 2015;27:974–980.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Danny J. Avalos
    • 1
  • Marc J. Zuckerman
    • 1
  • Alok Dwivedi
    • 2
  • Christopher Dodoo
    • 2
  • Jinendra Satiya
    • 3
  • Fernando J. Castro
    • 4
  1. 1.Division of GastroenterologyTexas Tech University Health Sciences Center El PasoEl PasoUSA
  2. 2.Biostatistics and Epidemiology Consulting LabTexas Tech University Health Sciences Center El PasoEl PasoUSA
  3. 3.University of Miami/JFK GME ConsortiumAtlantisUSA
  4. 4.Digestive Disease Center, Department of GastroenterologyCleveland Clinic FloridaWestonUSA

Personalised recommendations