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: It is unclear whether there is a shared pathway in the development of diverticular disease (DD) and potentially neoplastic colorectal lesions since both diseases are found in similar age groups and populations. Aim: To determine the association between DD and colorectal pre-neoplastic lesions in an African-American urban population. Methods: Data from 1986 patients who underwent colonoscopy at the Howard University Hospital from January 2012 through December 2012 were analyzed for this study. The presence of diverticula and polyps was recorded using colonoscopy reports. Polyps were further classified into adenoma or hyperplastic polyp based on histopathology reports. Multiple logistic regression was done to analyze the association between DD and colonic lesions. Results: Of the 1986 study subjects, 1,119 (56%) were females, 35% had DD and 56% had at least one polyp. There was a higher prevalence of polyps (70 vs. 49%; OR = 2.3; 95% CI: 1.9-2.8) and adenoma (43 vs. 25%; OR = 2.0; 95% CI: 1.7-2.5) in the diverticular vs. non-diverticula patients. Among patients who underwent screening colonoscopy, the presence of diverticulosis was associated with increased odds of associated polyps (OR = 9.9; 95% CI: 5.4-16.8) and adenoma (OR = 5.1; 95% CI: 3.4-7.8). Conclusion: Patients with DD are more likely to harbor colorectal lesions. These findings call for more vigilance on the part of endoscopists during colonoscopy in patients known to harbor colonic diverticula.

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.

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.