Prevalence of Colorectal Neoplasms in Asian Americans (original) (raw)
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Risk of colorectal adenomas in a multiethnic Asian patient population: Race does not matter
Journal of Gastroenterology and Hepatology, 2005
Background: Ethnic differences have been reported for colorectal polyps and large bowel cancer; although the supporting data is weak and insufficient to draw firm conclusions. Aim: We undertook this study to determine whether such racial disparity in colorectal adenomas exists in an ethnically mixed non-migrant population. The prevalence, histology and distribution of colonic polyps were documented as well as other known risk factors for colorectal malignancy. Methods: In this prospective cross-sectional study, 311 consecutive referred and self-referred multiracial patients attending for colonoscopy over a 41-month period in a private endoscopy center were recruited. The mean age of the study population was 51.8 ± 14 years (range 16-91). The male to female ratio was 1.1 and an ethnic breakdown as follows: 87 Malays, 115 Chinese and 109 Indians. Results: Sixty-three adenomas were recorded in 36 patients: six Malays, 19 Chinese and 11 Indians. Of these adenomas, 59 were polypoid, three flat and one depressed. The majority of adenomas 42/63 (67%) were distal to the splenic flexure as were all (10/10) the Duke's A carcinomas and 6/8 (75%) of the advanced cancers. Patients with adenoma(s) compared with those without (controls) were significantly older (P = 0.005), more likely to have a family history of colorectal cancer (P = 0.005), and showed a trend towards significance for ethnic group (P = 0.09) on univariate analysis. Using logistic regression analysis, only family history (P = 0.05) and age ≥ 50 years (P = 0.011) were found to be significantly associated with adenomas. Conclusion: Risk factors for colonic adenoma(s) in our cohort of symptomatic multiethnic patients attending for colonoscopy do not seem to differ from those reported elsewhere and, in particular, race does not appear to be a factor.
Family Medicine and Community Health
Objective: To investigate the incidence and trends in colorectal cancer (CRC) among Asian American populations in the United States. Methods: CRC incidence data from 1994 through 2013 were obtained from 13 Surveillance, Epidemiology, and End Results registries. SEER*Stat and IBM SPSS Statistics were used. Results: The age-adjusted incidence of CRC among Asian Americans decreased from 45.6 per 100,000 in 1994 to 33.0 per 100,000 in 2013, with the annual percent change being −1.8% (P<0.05). The incidences were higher for men, the elderly (aged 60 years or older), and several geographic areas. For those younger than 70 years, the rectal site was more affected compared with those aged 70 years or older, in whom the proximal site were more affected. Most patients presented with localized and regional stages. Men, 80 years or older, in situ stage, and some geographic areas such as Connecticut and California experienced significant incidence decreases in the 20-year observation period. Conclusion: Although CRC incidence has declined among Asian American populations in the United States in the past 2 decades, there are persistent differences by age and geographic areas. Further research is needed to guide the design and implementation of tailored strategies to reduce CRC outcome differences across Asian American populations.
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2004
This study examined subsite-specific colorectal cancer incidence rates and stage distributions for Asians and Pacific Islanders (API) and compared the API data with data for Whites and African Americans. Data included 336,798 invasive colorectal cancer incident cases for 1995 to 1999 from 23 population-based central cancer registries, representing about two thirds of API population in the United States. Age-adjusted rates, using the 2000 U.S. standard population, and age-specific rates and stage distributions were computed by anatomic subsite, race, and gender. All rates were expressed per 100,000. SEs and rate ratios were calculated for rate comparison. A significance level of 0.05 was used for all analyses. Overall, age-adjusted colorectal cancer incidence rates were significantly lower in API than in Whites and African Americans across anatomic subsites, particularly for proximal colon cancer in which rates were 40% to 50% lower in API males and females. Exception to this pattern...
The Prevalence of Colorectal Adenomas in Asymptomatic Korean Men and Women
Cancer Epidemiology, Biomarkers & Prevention, 2014
Background: Colorectal cancer incidence is rapidly rising in many Asian countries, with rates approaching those of Western countries. This study aimed to evaluate the prevalence and trends of colorectal adenomas by age, sex, and risk strata in asymptomatic Koreans. Methods: Cross-sectional study of 19,372 consecutive participants aged 20 to 79 years undergoing screening colonoscopy at the Center for Health Promotion of the Samsung Medical Center in Korea from January 2006 to June 2009. Results: Among participants at average risk, those without a history of colorectal polyps or a family history of colorectal cancer, the prevalence of colorectal adenomas and advanced adenomas were 34.5% and 3.1%, respectively, in men and 20.0% and 1.6%, respectively, in women. The prevalence of adenomas increased with age in both men and women, with a more marked increase for advanced adenoma. Participants with a family history of colorectal cancer or with a history of colorectal polyps had significan...
Alimentary Pharmacology and Therapeutics, 2005
Background: Colorectal cancer is one of the most common forms of gastrointestinal cancer in the world today. In the Asia-Pacific area, it is the fastest emerging gastrointestinal cancer. Aim: To determine the basic demographic features of patients with colorectal cancer and the anatomic distribution and characteristics of the tumour in a local Asian population. Methods: We conducted a review of consecutive patients who had undergone colonoscopy from 1999 to 2003 at the
Racial variation in colorectal polyp and tumor location
Journal of the National Medical Association, 2007
The incidence and mortality from colorectal cancer among whites have decreased, but they have remained unchanged among African Americans. To explain this disparity, we used the multicenter endoscopy database of the Clinical Outcomes Research Initiative to compare the prevalence of proximal polyps and tumors among asymptomatic African Americans and whites undergoing routine screening colonoscopy. African Americans and whites undergoing colonoscopy between January 1, 2002 and September 30, 2003 were considered for analysis. There were 145,175 index colonoscopy reports on unique patients. After applying exclusion criteria, 46,726 patients remained for analysis. Adjusting for age, gender, American Society of Anesthesiologists level, bowel preparation and endoscopic setting, African Americans were less likely to have polyps [adjusted odds ratio (OR) = 0.77; 95% confidence interval (CI) = 0.70-0.84]. However, the odds of having proximal polyps was higher in African Americans (OR = 1.30; 9...
Disparities in colorectal cancer screening rates among Asian Americans and non-Latino whites
Cancer, 2005
Among Asian Americans, colorectal cancer (CRC) is the second most commonly diagnosed cancer, and it is the third highest cause of cancer-related mortality. The 2001 California Health Interview Survey (CHIS 2001) was used to examine 1) CRC screening rates between different Asian-American ethnic groups compared with non-Latino whites and 2) factors related to CRC screening. The CHIS 2001 was a population-based telephone survey that was conducted in California. Responses about CRC screening were analyzed from 1771 Asian Americans age 50 years and older (Chinese, Filipino, South Asian, Japanese, Korean, and Vietnamese). The authors examined two CRC screening outcomes: individuals who ever had CRC screening and individuals who were up to date for CRC screening. For CRC screening, fecal occult blood test (FOBT), sigmoidoscopy/colonoscopy, and any other form of screening were examined. CRC screening of any kind was low in all populations, and Koreans had the lowest rate (49%). Multivariate analysis revealed that, compared with non-Latino whites, Koreans were less likely to undergo FOBT (odds ratio [OR], 0.40; 95% confidence interval [95% CI], 0.25–0.62), and Filipinos were the least likely to undergo sigmoidoscopy/colonoscopy (OR, 0.62; 95% CI, 0.44–0.88) or to be up to date with screening (OR, 0.68; 95% CI, 0.48–0.97). Asian Americans were less likely to undergo screening if they were older, male, less educated, recent immigrants, living with ≥ 3 individuals, poor, or uninsured. Asian-American populations, especially Koreans and Filipinos, are under-screened for CRC. Outreach efforts could be more focused on helping Asian Americans to understand the importance of CRC screening, providing accurate information in different Asian languages. Other strategies for increasing CRC screening may include using a more family-centered approach and using qualified translators. Cancer 2005. © 2005 American Cancer Society.