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Older Age, Black or Hispanic Race Tied to Higher Risk for Colorectal Cancer

Findings seen in a large study of veterans undergoing diagnostic colonoscopy

TUESDAY, June 22, 2021 (HealthDay News) — Age and race/ethnicity are independently associated with the overall risk for colorectal cancer (CRC) among veterans, according to a study published online May 28 in the Journal of Clinical Gastroenterology.

Thomas F. Imperiale, M.D., from Indiana University in Indianapolis, and colleagues assessed the effects of age, sex, and race/ethnicity on the risk for CRC and advanced neoplasia (AN) among veterans. The analysis included 90,598 veterans (aged 40 to 80 years) who had diagnostic or screening colonoscopy between 2002 and 2009 at one of 14 Veterans Affairs medical centers.

The researchers found that CRC prevalence was 1.3 percent and AN prevalence was 8.9 percent. For diagnostic colonoscopy, the adjusted CRC risk was higher than for screening colonoscopy (odds ratio [OR], 3.79; 95 percent confidence interval [CI], 3.19 to 4.50). CRC risk increased with age and was higher, but not statistically, for men overall (OR, 1.53; 95 percent CI, 0.97 to 2.39) in the diagnostic colonoscopy group and in the screening subgroup (OR, 2.24; 95 percent CI, 0.71 to 7.05). Additionally, CRC risk was higher overall for Blacks and Hispanics, but not in screening. AN prevalence was 9.2 percent in men and 3.9 percent in women (adjusted OR, 1.90; 95 percent CI, 1.60 to 2.25), and the prevalence increased with age. AN risk was higher in Blacks versus Whites overall (OR, 1.11; 95 percent CI, 1.04 to 1.20) and was lower in Hispanics (OR, 0.74; 95 percent CI, 0.55 to 0.98). Proximal CRC was more common in women than men, but there was no difference between the genders for proximal AN.

“A risk-based model that includes age, gender, and perhaps other features such as cigarette smoking and physical measures may be useful for both tailoring CRC screening and optimizing resource allocation within the Veterans Health Administration and in other health care systems,” the authors write.

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