Objectives Obesity is associated with the activation of the molecular pathways that increase the risk of colorectal cancer. Increasing body mass index may accelerate the development of adenomatous polyps, the antecedent lesion of colorectal cancer. The aim of this study was to assess the BMI effect on the risk of colonic polyp and adenoma in African American. Design and Methods We examined the records of 923 patients who underwent colonoscopy. Demographic and clinical data were collected before colonoscopy. Polyp and adenoma diagnosis were confirmed by pathology examinations. Results Overall, 43% of the patients were male, median age was 57 years and 77% had BMI≥25.0 kg/m2. The frequency of colorectal polyps and adenomas were 61% and 35%, respectively. BMI≥25.0 (OR=1.61, 95%CI=1.14-2.26), smoking (OR=1.61, 95%CI=1.15-2.26) and history of colon polyps (OR=1.64, 95%CI=1.09-2.47) were associated with higher risk of colon polyp. BMI≥25.0 (OR=1.81, 95%CI=1.24-2.62), age (OR=1.04, 95%CI=1.02-2.05 for each year), male gender (OR=1.38, 95%CI=1.02-1.86), and smoking (OR=1.73, 95%CI=1.23-2.42) were associated with higher risk of colon adenoma. Conclusion Male and overweight African Americans are at higher risk of colorectal adenoma. The findings of this study could be applied for risk stratification and modifying the colorectal cancer prevention including screening guideline in African Americans.

Background The disproportionately higher incidence of, and mortality from colorectal cancer (CRC) among African Americans (AA) led the American College of Gastroenterology to recommend screening starting at age 45 in 2005. Aim To determine the prevalence of colorectal neoplasia among 40–49 years old inner city African Americans (AA) and Hispanic Americans (HA). Methods We reviewed the medical records of 2435 inner city AA and HA who underwent colonoscopy regardless of indication and compared the prevalence of colorectal neoplasia between AA and HA patients. We used logistic regression models to calculate odds ratios (OR) and 95% confidence intervals (CI). Results There were 2,163 AA and 272 HA. There were 57% women in both groups. A total of 158 (7%) AA and 9 (3%) HA (P = 0.014) underwent the procedures for CRC screening. When compared to HA, AA had higher prevalence of any polyp (35% versus 18%, OR = 2.53; 95% CI: 1.82–3.52). Overall, AA had higher prevalence of colorectal neoplasia (adenoma and cancer) when compared to HA (16% versus 10%; OR = 1.68; 95% CI: 1.10–2.56). Conclusion We observed a higher frequency of colorectal neoplasia among 40–49 year-old AA as compared to HA suggesting an increased susceptibility to CRC risk in this population.

BackgroundAfrican Americans have disproportionately higher incidence and death rates of colorectal cancer among all ethnic groups in the United States. Several lifestyle factors (e.g. diet, physical activity and alcohol intake) have been suggested as risk factors for colorectal cancer. Stressful life events have also been identified as risk factors for colorectal cancer. The association between stressful life events and colon polyps, which are precursors of colorectal cancer, has yet to be determined.We aimed to evaluate the relationship between stressful life events and the presence of colon polyps and adenomas in African American men and women.MethodsIn this cross-sectional study, 110 participants were recruited from a colon cancer screening program at Howard University Hospital. Participants completed an 82-item Life Events Questionnaire (Norbeck 1984), assessing major events that have occurred in the participants’ life within the past 12 months. Participants also reported whether the event had a positive or negative impact. Three scores were derived (total, positive, and negative).ResultsTotal life events scores were higher (Median [M] = 29 and Interquartile range [IQR] = 18-43) in patients with one or more polyps compared to patients without polyps (M, IQR = 21,13-38; P = 0.029). Total, positive or negative Life Events scores did not differ significantly between normal and adenoma patients. Total, negative and positive Life Events scores did not differ between patients who underwent diagnostic colonoscopy (symptomatic) and patients who underwent colonoscopy for colon cancer screening (asymptomatic) and patients for surveillance colonoscopies due to a personal history of colon polyps. Linear regression analysis indicated that male gender is associated with 9.0 unit lower total Life Events score (P = 0.025).ConclusionThis study suggests that patients who experienced total life events may be at higher risk of having colon polyps and adenomas which indicates an association between stress and the development of colorectal polyps.

Our results indicated that HD scope was more sensitive in diagnosis of adenoma than ST scope. Clinical diagnosis of HPP with either scope is less accurate compared to adenoma. Colonoscopy diagnosis is not yet fully matched with pathologic diagnosis of colon polyp. However with the advancement of both imaging and training, it may be possible to increase the sensitivity and specificity of the scopes and hence save money for eliminating time and the cost of Immunohistochemistry/pathology.