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Black Men Less Likely to Have Advanced Neoplasia at Screening

MONDAY, July 8 (HealthDay News) -- Although blacks are more likely than whites to be diagnosed with and die from colorectal cancer, black men are less likely to have advanced colorectal neoplasia (ACN) at screening, according to a study published in the July 2 issue of the Annals of Internal Medicine.

Paul C. Schroy III, M.D., M.P.H., from Boston University, and colleagues compared the prevalence of presymptomatic ACN in 1,172 asymptomatic, average-risk whites and 1,681 asymptomatic, average-risk blacks (50 to 79 years old) undergoing screening colonoscopy. ACN was defined as a tubular adenoma 10 mm or more in size, any adenoma with villous features or high-grade dysplasia, any dysplastic serrated lesion, or invasive cancer.

The researchers found that whites had a significantly higher prevalence of ACN than blacks (6.8 versus 5.0 percent), which varied significantly by sex. After controlling for various risk factors, black men were significantly less likely than white men to have ACN (adjusted odds ratio, 0.59). There was no significant difference for women. After adjusting for age and sex, proximal disease was significantly more common among blacks with ACN (52 versus 39 percent).

"Black men are less likely than white men to have advanced colorectal neoplasia at screening colonoscopy in a safety-net health care setting," Schroy and colleagues conclude. "Disparities in access to screening and differential exposure to modifiable risk factors rather than genetic or biological factors may be largely responsible for the higher incidence of colorectal cancer among black men."

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