Houston VA HSR&D Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.
Inflamm Bowel Dis. 2012 Jun;18(6):1011-7. doi: 10.1002/ibd.21840. Epub 2011 Aug 29.
African Americans are at an increased risk of developing sporadic colorectal cancer (CRC) compared to Caucasians. Ulcerative colitis (UC) is a risk factor for developing CRC; however, risk differences for CRC between African Americans and Caucasians with UC are unknown.
We performed a cohort study of patients with a diagnosis of UC during fiscal years 1998 to 2009 using the national Veterans Affairs administrative datasets. Cumulative CRC incidence rates and incidence rate ratios were calculated and Cox proportional hazards models were used to examine the association between race and the CRC risk.
The cohort comprised of 20,949 patients with UC. A total of 168 incident cases of CRC were identified during 112,243 patient-years (PY) of follow-up; overall CRC incidence rate was 163/100,000 PY (95% confidence interval [CI] 139-187/100,000 PY). The CRC incidence rates were 158/100,000 PY (95% CI 134-181/100,000 PY) and 180/100,000 PY (95% CI 155-205/100,000 PY) in Caucasians and African Americans, respectively, with an incidence rate ratio of 1.17 (95% CI 0.69-1.97). The 3, 5, and 10-year cumulative incidence rates for CRC were 0.36%, 0.76%, 1.79% for African Americans and 0.41%, 0.76%, 1.43% for Caucasians. African Americans were not at an increased risk for CRC (adjusted hazard ratio: 1.10, 95% CI 0.65-1.87) compared to Caucasians.
In a national cohort of UC patients the risk of developing CRC in African Americans was no higher than in Caucasians. The reasons for lack of racial differences compared to sporadic CRC are not clear; access to care, genetic factors, and molecular pathways require further study.
与白人相比，非裔美国人罹患散发性结直肠癌（CRC）的风险增加。溃疡性结肠炎（UC）是 CRC 的一个危险因素；然而，非裔美国人和白人 UC 患者 CRC 的风险差异尚不清楚。
我们使用国家退伍军人事务部管理数据集，对 1998 年至 2009 年期间诊断为 UC 的患者进行了队列研究。计算累积 CRC 发病率和发病率比，并使用 Cox 比例风险模型检查种族与 CRC 风险之间的关联。
该队列包括 20949 名 UC 患者。在 112243 患者年（PY）的随访期间，共发现 168 例 CRC 病例；总 CRC 发病率为 163/100000PY（95%置信区间[CI]为 139-187/100000PY）。CRC 发病率分别为 158/100000PY（95%CI 为 134-181/100000PY）和 180/100000PY（95%CI 为 155-205/100000PY），白人发病率为 1.17（95%CI 为 0.69-1.97）。CRC 的 3、5 和 10 年累积发病率分别为非裔美国人 0.36%、0.76%、1.79%，白种人 0.41%、0.76%、1.43%。与白人相比，非裔美国人 CRC 的发病风险没有增加（调整后的危险比：1.10，95%CI 为 0.65-1.87）。
在 UC 患者的全国队列中，非裔美国人发生 CRC 的风险并不高于白人。与散发性 CRC 相比，缺乏种族差异的原因尚不清楚；获得医疗保健、遗传因素和分子途径需要进一步研究。
