在接受筛查结肠镜检查的黑人和拉丁裔个体中检测结直肠肿瘤：一项前瞻性队列研究。
Colorectal neoplasia detection among black and Latino individuals undergoing screening colonoscopy: a prospective cohort study.
机构信息
Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Division of Cancer Prevention and Control, Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
出版信息
Gastrointest Endosc. 2014 Mar;79(3):466-72. doi: 10.1016/j.gie.2013.12.020.
BACKGROUND
Most prospective studies of screening colonoscopy (SC) in average-risk, asymptomatic individuals have included few minority individuals. Little is known about the prevalence and distribution of adenomas found at screening colonoscopy among black and Latino individuals.
OBJECTIVE
To determine the prevalence and distribution of histologically confirmed adenomas among black and Latino participants enrolled in a prospective SC study.
DESIGN
Cross-sectional analysis of consecutive patients undergoing SC between 2008 and 2011.
SETTING
Urban academic medical center.
PATIENTS
Average risk, asymptomatic black and Latino patients aged ≥50 years undergoing SC.
INTERVENTION SC MAIN OUTCOME MEASUREMENTS
Adenoma prevalence and distribution by ethnic group.
RESULTS
A total of 584 patients (270 black, 314 Latino) completed SC. Overall, 26.4% had adenomas, and 20% had proximal adenomas. Advanced adenomas occurred in 11.5% (12.2% black vs 10.8% Latino; P = .21) and proximal advanced adenomas in 7.5% (5.9% black vs 8.9% Latino; P = .17). These rates were at least as high as those of other studies that enrolled mainly white participants.
LIMITATIONS
Lack of comparison group of white patients.
CONCLUSION
The prevalence of adenomas, advanced adenomas, and proximal adenomas was high in both black and Latino participants. The high prevalence of clinically significant proximal lesions has implications for the choice of colon cancer screening test and colonoscopic surveillance intervals.
背景
大多数针对无症状、平均风险个体的筛查性结肠镜检查（SC）的前瞻性研究中，纳入的少数族裔个体较少。关于黑人和拉丁裔个体在筛查性结肠镜检查中发现的腺瘤的患病率和分布情况，人们知之甚少。
目的
确定参加前瞻性 SC 研究的黑人和拉丁裔个体中，经组织学证实的腺瘤的患病率和分布情况。
设计
对 2008 年至 2011 年间接受 SC 的连续患者进行的横断面分析。
地点
城市学术医疗中心。
患者
年龄≥50 岁、无症状、平均风险的黑人和拉丁裔接受 SC 的患者。
干预措施
SC 的主要观察终点为腺瘤的患病率和分布情况。
结果
共有 584 例患者（270 例黑人，314 例拉丁裔）完成了 SC。总体而言，26.4%的患者有腺瘤，20%的患者有近端腺瘤。高级别腺瘤的发生率为 11.5%（黑人 12.2%，拉丁裔 10.8%；P=.21），近端高级别腺瘤的发生率为 7.5%（黑人 5.9%，拉丁裔 8.9%；P=.17）。这些发生率与其他主要纳入白人患者的研究相似。
局限性
缺乏白人患者的对照组。
结论
黑人和拉丁裔个体中腺瘤、高级别腺瘤和近端腺瘤的患病率均较高。临床上有意义的近端病变的高发生率对结肠癌筛查试验的选择和结肠镜监测间隔具有重要意义。
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