Digestive Diseases and Sciences

, Volume 57, Issue 2, pp 481–488 | Cite as

Prevalence of Colon Polyps Detected by Colonoscopy Screening of Asymptomatic Hispanic Patients

  • Brent Lee
  • Jennifer Holub
  • Dawn Peters
  • David Lieberman
Original Article



Compared with whites, Hispanics have lower incidence of and mortality from colorectal cancer. The purpose of this study was to determine whether asymptomatic Hispanics undergoing colonoscopy screening also have lower age-adjusted incidence of polyps ≥10 mm. Such data could be used to formulate future screening guidelines.


The objectives of this study were to measure and analyze the prevalence and location of polyps sized ≥10 mm in asymptomatic white and Hispanic patients who received colonoscopy screening.


Colonoscopy data were prospectively collected from the Clinical Outcomes Research Initiative database, which includes data from a consortium of 66 adult gastrointestinal practice sites in the United States. Asymptomatic white (n = 146,798) and Hispanic (n = 7,654) patients who received colonoscopy screening from 2004 to 2007 were identified. The prevalence of any polyps ≥10 mm and of proximal polyps ≥10 mm was adjusted for age, sex, practice site type, and family history of colorectal cancer in a multivariate analysis.


There was no significant difference between prevalence of polyps ≥10 mm in Hispanic and white patients (5.8% vs. 6.2%; P = 0.11; adjusted OR 0.94; 95% CI 0.85–1.03). There was also no significant difference between prevalence of proximal polyps ≥10 mm in Hispanics and whites (adjusted OR 1.05; 95% CI 0.87–1.27).


Despite lower incidence of colorectal cancer, the risk of polyps ≥10 mm for Hispanic patients undergoing colonoscopy screening is similar to that for whites. These data emphasize the importance of encouraging timely colorectal cancer screening in Hispanics. Our findings support the application of similar recommendations for colorectal cancer screening of Hispanics and whites.


Hispanic Colorectal cancer Colon polyps Colonoscopy Screening 



This project was supported with funding from NIDDK UO1 DK57132. In addition, the practice network (Clinical Outcomes Research Initiative; CORI) has received support from the following entities to support the infrastructure of the practice-based network: AstraZeneca, Bard International, Pentax USA, ProVation, Endosoft, GIVEN Imaging, and Ethicon. The commercial entities had no involvement in this research. Dr Lieberman is the executive director of the CORI, a non-profit organization that receives funding from federal and industry sources. The CORI database was used in this study. This relationship was reviewed and managed by the OHSU and VA Conflict of Interest in Research Committees.


  1. 1.
    American Cancer Society. Colorectal Cancer Facts & Figures 2011–2013. Atlanta: American Cancer Society; 2011.Google Scholar
  2. 2.
    Lieberman DA, Holub JL, Moravec MD, Eisen GM, Peters D, Morris CD. Prevalence of colon polyps detected by colonoscopy screening in asymptomatic black and white patients. JAMA. 2008;300:1417–1422.PubMedCrossRefGoogle Scholar
  3. 3.
    Theuer CP, Wagner JL, Taylor TH, et al. Racial and ethnic colorectal cancer patterns affect the cost-effectiveness of colorectal cancer screening in the United States. Gastroenterology. 2001;120:848–856.PubMedCrossRefGoogle Scholar
  4. 4.
    American Cancer Society. Cancer Facts and Figures for Hispanics/Latinos 2009–2011. Atlanta: American Cancer Society; 2009.Google Scholar
  5. 5.
    Francois F, Park J, Bini EJ. Colon pathology detected after a positive screening flexible sigmoidoscopy: a prospective study in an ethnically diverse cohort. Am J Gastroenterol. 2006;101:823–830.PubMedCrossRefGoogle Scholar
  6. 6.
    Theuer CP, Taylor TH, Brewster WR, Campbell BS, Becerra JC, Anton-Culver H. The topography of colorectal cancer varies by race/ethnicity and affects the utility of flexible sigmoidoscopy. Am Surg. 2001;67:1157–1161.PubMedGoogle Scholar
  7. 7.
    Levin B, Lieberman DA, McFarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008;134:1570–1595.PubMedCrossRefGoogle Scholar
  8. 8.
    Shavers VL, Jackson MC, Sheppard VB. Racial/ethnic patterns of uptake of colorectal screening, National Health Interview Survey 2000–2008. J Natl Med Assoc. 2010;102:621–635.PubMedGoogle Scholar
  9. 9.
    Ananthakrishnan AN, Schellhase KG, Sparapani RA, Laud PW, Neuner JM. Disparities in colon cancer screening in the Medicare population. Arch Intern Med. 2007;167:258–264.PubMedCrossRefGoogle Scholar
  10. 10.
    O’Malley AS, Forrest CB, Feng S, Mandelblatt J. Disparities despite coverage: gaps in colorectal cancer screening among Medicare beneficiaries. Arch Intern Med. 2005;165:2129–2135.PubMedCrossRefGoogle Scholar
  11. 11.
    Subramanian S, Amonkar MM, Hunt TL. Use of colonoscopy for colorectal cancer screening: evidence from the 2000 National Health Interview Survey. Cancer Epidemiol Biomarkers Prev. 2005;14:409–416.PubMedCrossRefGoogle Scholar
  12. 12.
    Shapiro JA, Seeff LC, Nadel MR. Colorectal cancer-screening tests and associated health behaviors. Am J Prev Med. 2001;21:132–137.PubMedCrossRefGoogle Scholar
  13. 13.
    Jerant AF, Fenton JJ, Franks P. Determinants of racial/ethnic colorectal cancer screening disparities. Arch Intern Med. 2008;168:1317–1324.PubMedCrossRefGoogle Scholar
  14. 14.
    Shah M, Zhu K, Potter J. Hispanic acculturation, utilization of colorectal cancer screening in the United States. Cancer Detect Prev. 2006;30:306–312.PubMedCrossRefGoogle Scholar
  15. 15.
    Shokar NK, Carlson CA, Weller SC. Factors associated with racial/ethnic differences in colorectal cancer screening. J Am Board Fam Med. 2008;21:414–426.PubMedCrossRefGoogle Scholar
  16. 16.
    Lieberman D, Moravec M, Holub J, Michaels L, Eisen G. Polyp size and advanced histology in patients undergoing colonoscopy screening: implications for CT colonography. Gastroenterology. 2008;135:1100–1105.PubMedCrossRefGoogle Scholar
  17. 17.
    Sonnenberg A, Amorosi SL, Lacey MJ, Lieberman DA. Patterns of endoscopy in the United States: analysis of data from the Centers for Medicare and Medicaid Services and the National Endoscopic Database. Gastrointest Endosc. 2008;67:489–496.PubMedCrossRefGoogle Scholar
  18. 18.
    Horner MJ, Ries LAG, Krapcho M, et al., eds. SEER Cancer Statistics Review, 1975–2006. Bethesda, MD: National Cancer Institute; 2009.Google Scholar
  19. 19.
    Clegg LX, FP Li, Hankey BF, Chu K, Edwards BK. Cancer survival among US whites and minorities: a SEER (Surveillance, Epidemiology, and End Results) Program population-based study. Arch Intern Med. 2002;162:1985–1993.PubMedCrossRefGoogle Scholar
  20. 20.
    Centers for Disease Control, Prevention (CDC). Vital signs: colorectal cancer screening among adults aged 50–75 years—United States, 2008. MMWR Morb Mortal Wkly Rep. 2010;59:808–812.Google Scholar
  21. 21.
    Chien C, Morimoto LM, Tom J, Li CI. Differences in colorectal carcinoma stage and survival by race and ethnicity. Cancer. 2005;104:629–639.PubMedCrossRefGoogle Scholar
  22. 22.
    Klabunde CN, Cronin KA, Breen N, Waldron WR, Ambs AH, Nadel MR. Trends in colorectal cancer test use among vulnerable populations in the United States. Cancer Epidemiol Biomarkers Prev. 2011;20:1611–1621.Google Scholar
  23. 23.
    White A, Vernon SW, Franzini L, XL Du. Racial, ethnic disparities in colorectal cancer screening persisted despite expansion of Medicare’s screening reimbursement. Cancer Epidemiol Biomarkers Prev. 2011;20:811–817.PubMedCrossRefGoogle Scholar
  24. 24.
    Kolonel LN. Cancer patterns of four ethnic groups in Hawaii. J Natl Cancer Inst. 1980;65:1127–1139.PubMedGoogle Scholar
  25. 25.
    Maskarinec G, Noh JJ. The effect of migration on cancer incidence among Japanese in Hawaii. Ethn Dis. 2004;14:431–439.PubMedGoogle Scholar
  26. 26.
    Soto-Salgado M, Suarez E, Calo W, Cruz-Correa M, Figueroa-Valles NR, Ortiz AP. Incidence and mortality rates for colorectal cancer in Puerto Rico and among Hispanics, non-Hispanic whites, and non-Hispanic blacks in the United States, 1998–2002. Cancer. 2009;115:3016–3023.PubMedCrossRefGoogle Scholar
  27. 27.
    Singh GK, Hiatt RA. Trends and disparities in socioeconomic and behavioural characteristics, life expectancy, and cause-specific mortality of native-born and foreign-born populations in the United States, 1979–2003. Int J Epidemiol. 2006;35:903–919.PubMedCrossRefGoogle Scholar
  28. 28.
    Shaib YH, Rabaa E, Qaseem T. The site distribution and characteristics of colorectal adenomas in Hispanics: a comparative study. Am J Gastroenterol. 2002;97:2100–2102.PubMedCrossRefGoogle Scholar
  29. 29.
    Lieberman DA, Weiss DG, Bond JH, Ahnen DJ, Garewal H, Chejfec G. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380. N Engl J Med. 2000;343:162–168.PubMedCrossRefGoogle Scholar
  30. 30.
    Doubeni CA, Laiyemo AO, Reed G, Field TS, Fletcher RH. Socioeconomic, racial patterns of colorectal cancer screening among Medicare enrollees in 2000 to 2005. Cancer Epidemiol Biomarkers Prev. 2009;18:2170–2175.PubMedCrossRefGoogle Scholar
  31. 31.
    Regula J, Rupinski M, Kraszewska E, et al. Colonoscopy in colorectal-cancer screening for detection of advanced neoplasia. N Engl J Med. 2006;355:1863–1872.PubMedCrossRefGoogle Scholar
  32. 32.
    Jass JR. Hyperplastic polyps and colorectal cancer: is there a link? Clin Gastroenterol Hepatol. 2004;2:1–8.PubMedCrossRefGoogle Scholar
  33. 33.
    Butterly LF, Chase MP, Pohl H, Fiarman GS. Prevalence of clinically important histology in small adenomas. Clin Gastroenterol Hepatol. 2006;4:343–348.PubMedCrossRefGoogle Scholar
  34. 34.
    Fennerty MB, Davidson J, Emerson SS, Sampliner RE, Hixson LJ, Garewal HS. Are endoscopic measurements of colonic polyps reliable? Am J Gastroenterol. 1993;88:496–500.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Brent Lee
    • 1
  • Jennifer Holub
    • 1
  • Dawn Peters
    • 1
  • David Lieberman
    • 1
  1. 1.Oregon Health & Science UniversityPortlandUSA

Personalised recommendations