ACG: Weight, Race, Male Gender May Increase Risk of Colorectal Cancer

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(ChemotherapyAdvisor) – African American and Hispanic men who are overweight may be at greater risk for precancerous polyps that may lead to colorectal cancer (CRC) if not detected early, and men overall are at greater risk of CRC, according to two studies presented at the American College of Gastroenterology's 77th Annual Scientific Meeting in Las Vegas, LV.

The first study found body mass index (BMI) appears to have a linear association with rates of advanced adenoma detection in African American and Hispanic males, with a trend towards higher right-sided advanced adenomas also observed, noted Shashideep Singhal, MD, from The Brooklyn Hospital Center, Brooklyn, NY. The study included 895 participants reporting for screening colonoscopy; mean age was 73 years; the majority were female; 74% were African American, and 26% were Hispanic.

Investigators divided the subjects into five groups based on BMI, including healthy weight, overweight, moderately obese, severely obese, and morbidly obese (the latter excluded due to small sample size). Total adenoma detection rates were 14%, 12.9%, 13.9%, and 16.3% in each of the four groups, respectively, with no statistical differences. Incidence of right-sided advanced adenomas was higher with increasing BMI (60%, 60%, 64.3% and 71.4%, respectively); however, this trend was not observed in females.

Dr. Singhal said while these findings need to be confirmed with larger studies, they may have useful implications for designing preventive strategies in high-risk populations; specifically, identifying patients who are at high risk and increasing colonoscopy screening intervals.

In the second study, Praveen Guturu, MD, and colleagues from The University of Texas Medical Branch retrospectively reviewed data from all average risk screening colonoscopies performed between 2006 and 2011 to determine and compare prevalence and numbers needed to screen for adenomas, advanced adenomas, and CRC in different age groups among men and women.

Of the 2,388 patients, 51 % were women. Overall, men in the study group had a significantly higher prevalence of adenomas (32% vs 23%; P<0.0001) and advanced adenomas (8% vs 5%; P=0.006) vs women and the prevalence of CRC was higher in men, but did not reach statistical significance (0.5% vs. 0.2%, P=0.3).

In the 50-59 year age group, adenoma prevalence was significantly higher in men compared with women (29% vs 19%); however, no significant difference in prevalence of adenomas and advanced adenomas were observed among men in the 60-69 age group and over 70 group vs women.

“Our study suggests that men might develop advanced colon polyps at an earlier age compared to women and this information will help us design appropriate screening and surveillance guidelines in future,'' said Dr. Guturu.

Link to abstract (select Oral & Posters, Browse by Number and select Abstract Number P547 and P1095):

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